Data from a large-scale observational study of pregnant women with systemic inflammatory conditions (n = 4,961) shows that the risk of serious infection is similar among those taking steroids (3.4%), non-biologics (2.3%) or TNF inhibitors (1.5%). Comparisons between these groups found no statistically significant differences, giving hazard ratios for non-biologics versus steroids, TNF inhibitors versus steroids, and TNF inhibitors versus non-biologics of 0.81, 0.91 and 1.36, respectively. Dose–response analysis indicated that high steroid doses were independently associated with an increased risk of serious infection in pregnancy.
References
Desai, R. J. et al. Risk of serious infections associated with use of immunosuppressive agents in pregnant women with autoimmune inflammatory conditions: cohort study. BMJ http://dx.doi.org/10.1136/bmj.j895 (2017)
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McHugh, J. Therapeutics and risk of infection in pregnancy. Nat Rev Rheumatol 13, 258 (2017). https://doi.org/10.1038/nrrheum.2017.45
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DOI: https://doi.org/10.1038/nrrheum.2017.45