Continuing to use tumor necrosis factor (TNF) inhibitors during pregnancy does not result in worse fetal or obstetric outcomes and may even decrease the risk of severe maternal infections during pregnancy, according to new research. TNF inhibitors are commonly prescribed for inflammatory forms of arthritis that have not improved with other treatments. Despite studies suggesting their safety for pregnant women, many stop taking them out of fear of harming the fetus.
To further evaluate the safety of continuing TNF inhibitors during pregnancy, researcher Anna Molto and her colleagues conducted a study using data from a nationwide French health insurance database to emulate a randomized clinical trial. The study included over 2,000 women treated with TNF inhibitors between 2008 and 2017, identifying no statistically significant difference in poor obstetric, fetal, or infant outcomes. Furthermore, women who continued using TNF inhibitors were less likely to be hospitalized for severe infections during pregnancy for six weeks postpartum compared to those who discontinued treatment.
Molto notes that these findings contribute to the increasing data on the safety of TNF inhibitors during pregnancy, and if rheumatologists consider discontinuing the medication due to infection risk, it may not be justified. However, she acknowledges the limitations of relying on claims data, and further testing with randomized controlled trials is needed to confirm these findings. Ultimately, this study suggests that TNF inhibitors are safe for pregnant women and may offer potential benefits for reducing maternal infections.
