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Risk of congenital anomalies in infants born to women with autoimmune disease using biologics before or during pregnancy: a population-based cohort study

1, 2, 3, 4, 5

  1. University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver; Collaboration for Outcomes Research and Evaluation, Vancouver; and Arthritis Research Canada, Richmond, Canada.
  2. University of British Columbia Faculty of Medicine, Department of Obstetrics & Gynecology, Vancouver, Canada.
  3. University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver; Collaboration for Outcomes Research and Evaluation, Vancouver; Centre for Health Evaluation & Outcomes Sciences, Vancouver, Canada.
  4. University of British Columbia Faculty of Medicine, Department of Medicine, Division of Rheumatology, Vancouver, Canada.
  5. University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver; Collaboration for Outcomes Research and Evaluation, Vancouver; and Arthritis Research Canada, Richmond, Canada. mary.devera@mail.ubc.ca

CER11853 Submission on line
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
To determine the association between perinatal biologic use and congenital anomalies in women with autoimmune disease.
METHODS:
We linked population-based administrative health data including information on all medications with a perinatal registry in British Columbia, Canada. Women with one or more autoimmune diseases who had pregnancies between January 1st, 2002 and December 31st, 2012 were included. Exposure to biologics was defined as having at least one biologic prescription 3 months before conception or during the first trimester of pregnancy. Each exposed pregnancy was matched with five unexposed pregnancies using high dimensional propensity scores (HDPS). Logistic regression modelling was used to evaluate the association between biologics use and congenital anomalies.
RESULTS:
The HDPS-matched cohort included 117 pregnancies (107 women) exposed to biologics, and 585 pregnancies (562 women) that were not exposed to biologics during the period of interest; 6% of newborns had ≥1 congenital anomalies at birth, in the exposed and unexposed groups. There were no obvious patterns with regards to the congenital anomalies observed in the biologics exposed group. In primary analysis, the OR for the association between biologic exposure and congenital anomalies was 1.06 (95%CI 0.46–2.47). Secondary and sensitivity analyses did not change the results appreciably.
CONCLUSIONS:
These population-based data suggest that the use of biologics before and during pregnancy is not associated with an increased risk of congenital anomalies.

PMID: 30943142 [PubMed]

Received: 26/10/2018 - Accepted : 04/02/2019 - In Press: 18/03/2019