PMID- 37973775
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240325
IS  - 1933-7205 (Electronic)
IS  - 1933-7191 (Print)
IS  - 1933-7191 (Linking)
VI  - 31
IP  - 4
DP  - 2024 Apr
TI  - Effect of Anti-TNF Biologic Exposure During Pregnancy on Villitis of Unknown 
      Etiology Diagnoses in Patients with Autoimmune Disease.
PG  - 997-1005
LID - 10.1007/s43032-023-01402-w [doi]
AB  - Tumor necrosis factor-alpha (TNF-alpha) antagonists are highly effective in controlling 
      autoimmune diseases. This has led to speculation that they might also be useful 
      in treating inflammatory placental conditions, such as chronic villitis of 
      unknown etiology (VUE). VUE affects 10-15% of term placentas and is associated 
      with recurrent fetal growth restriction (FGR) and pregnancy loss. We aimed to 
      evaluate outcomes in patients with autoimmune diseases with and without 
      anti-TNF-alpha biologic exposure during gestation. This retrospective cohort study 
      compared pregnant women with autoimmune disease taking anti-TNF-alpha biologics 
      (n = 89) to pregnant women with autoimmune disease but not taking a biologic 
      (n = 53). We extracted data on all patients meeting our inclusion criteria over a 
      20-year period. Our primary outcome was the diagnosis of VUE by histology. Our 
      secondary outcomes were maternal and neonatal complications such as preeclampsia, 
      FGR, and neonatal intensive care admission. Kruskal-Wallis and chi-squared tests 
      were performed as appropriate for statistical analysis. Maternal characteristics 
      were comparable between groups, and there was no increase in adverse pregnancy 
      outcomes based on anti-TNF-alpha treatment. Exposure to anti-TNF-alpha therapy had no 
      significant effect on the incidence of VUE or other obstetric complications. 
      Within the cohort exposed to anti-TNF-alpha biologics during pregnancy, the rate of 
      VUE was 9.3%, which is comparable to the reported general population risk. Our 
      data support the safety profile of biologic use in pregnancy.
CI  - (c) 2023. The Author(s), under exclusive licence to Society for Reproductive 
      Investigation.
FAU - Scott, Hannah M
AU  - Scott HM
AD  - Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Ave. SW, 
      Rochester, MN, 55905, USA.
FAU - Mehta, Ramila
AU  - Mehta R
AD  - Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
FAU - Branda, Megan E
AU  - Branda ME
AD  - Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
FAU - Hughes, Jennifer
AU  - Hughes J
AD  - ICON PLC, Nashville, TN, USA.
FAU - Kane, Sunanda V
AU  - Kane SV
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Girard, Sylvie
AU  - Girard S
AD  - Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Ave. SW, 
      Rochester, MN, 55905, USA.
AD  - Department of Immunology, Mayo Clinic, Rochester, MN, USA.
FAU - Norgan, Andrew P
AU  - Norgan AP
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
FAU - Theiler, Regan N
AU  - Theiler RN
AD  - Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Ave. SW, 
      Rochester, MN, 55905, USA.
FAU - Enninga, Elizabeth Ann L
AU  - Enninga EAL
AUID- ORCID: 0000-0003-3621-7335
AD  - Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Ave. SW, 
      Rochester, MN, 55905, USA. Enninga.elizabethann@mayo.edu.
AD  - Department of Immunology, Mayo Clinic, Rochester, MN, USA. 
      Enninga.elizabethann@mayo.edu.
LA  - eng
GR  - K12 HD065987/HD/NICHD NIH HHS/United States
PT  - Journal Article
DEP - 20231116
PL  - United States
TA  - Reprod Sci
JT  - Reproductive sciences (Thousand Oaks, Calif.)
JID - 101291249
RN  - 0 (Tumor Necrosis Factor Inhibitors)
RN  - 0 (Biological Products)
SB  - IM
MH  - Infant, Newborn
MH  - Humans
MH  - Pregnancy
MH  - Female
MH  - Placenta/pathology
MH  - Tumor Necrosis Factor Inhibitors/adverse effects
MH  - *Placenta Diseases/diagnosis
MH  - Chorionic Villi/pathology
MH  - Retrospective Studies
MH  - *Chorioamnionitis
MH  - Pregnancy Outcome
MH  - Fetal Growth Retardation/chemically induced/pathology
MH  - *Autoimmune Diseases/diagnosis/drug therapy/complications
MH  - *Biological Products/adverse effects
PMC - PMC10960686
MID - NIHMS1954453
OTO - NOTNLM
OT  - Autoimmune disease
OT  - Biologic therapy
OT  - Chronic villitis
OT  - Immunotherapy
OT  - Placenta
OT  - Pregnancy
OT  - Tumor necrosis factor alpha/alpha
COIS- Conflicts of Interest: SVK is a consultant for Fresenius Kabi and Janssen, which 
      both produce anti-TNF molecules. RNT is an advisor to Delfina and has a know-how 
      agreement with HeraMed. The remaining authors report no conflict of interest.
EDAT- 2023/11/17 15:26
MHDA- 2024/03/25 06:43
PMCR- 2024/10/01
CRDT- 2023/11/16 23:19
PHST- 2023/06/21 00:00 [received]
PHST- 2023/11/04 00:00 [accepted]
PHST- 2024/10/01 00:00 [pmc-release]
PHST- 2024/03/25 06:43 [medline]
PHST- 2023/11/17 15:26 [pubmed]
PHST- 2023/11/16 23:19 [entrez]
AID - 10.1007/s43032-023-01402-w [pii]
AID - 10.1007/s43032-023-01402-w [doi]
PST - ppublish
SO  - Reprod Sci. 2024 Apr;31(4):997-1005. doi: 10.1007/s43032-023-01402-w. Epub 2023 
      Nov 16.