Anti-TNFs may reduce GDM risk in pregnant women with IBD

Pregnant women with inflammatory bowel disease (IBD) who used antitumour necrosis factor (anti-TNF) therapy are at reduced risk of developing gestational diabetes mellitus (GDM), reports a study.

Some 3,695 pregnant women with IBD were identified, of whom 338 (9.2 percent) had exposure to anti-TNF therapy. Fewer cases of GDM were observed in women exposed to anti-TNFs than those with no exposure (7.1 percent vs 11.0 percent). 

The crude risk ratio (RR) for GDM risk was 0.64 (95 percent confidence interval [CI], 0.43–0.96), while the weighted RRs were 0.68 (95 percent CI, 0.55–0.84). The weighted RR was 0.70 (95 percent CI, 0.41–1.18) when compared with the immunosuppressant group, 0.71 (95 percent CI, 0.52–0.95) relative to the 5-aminosalicylate group, and 0.85 (95 percent CI, 0.59–1.24) versus the untreated group.

“GDM risk may become a consideration in the decision-making process when choosing treatment options for pregnant women with a risk factor for GDM,” the researchers said. 

This nationwide cohort study involved IBD patients in Korea from 2010 to 2021 and identified anti-TNF exposure from the last menstrual period (LMP) to LMP + 140 days. GDM development was evaluated from LMP + 41 days to delivery.

Researchers carried out overlap weighting to balance the covariates and measured the RRs with 95 percent CIs using a generalized linear mixed model. They then compared the anti-TNF group with the unexposed groups, as well as with the immunosuppressant, 5-aminosalicylate, and untreated groups.