Infant psychomotor development not harmed by biologic exposure in utero, during breastfeeding

Exposure to biologics for inflammatory bowel disease (IBD) in utero or during breastfeeding does not appear to impair psychomotor development in infants, according to a study.

Researchers looked at mothers and their infants from an ongoing prospective, observational registry of pregnant women with IBD enrolled at 60 centres across Spain. Mothers received follow-up care throughout each trimester of pregnancy and postpartum.

The primary outcome of psychomotor development in infants was measured using the Spanish version of the Ages and Stages Questionnaire 3rd edition (ASQ-3) during the first year of life. An ASQ-3 score below the normal limit in any domain was considered abnormal.

The analysis included 352 children born to 343 women. Exposure to biologics occurred among 134 infants (38.1 percent) during pregnancy and 80 infants (22.7 percent) during lactation, including five who were exclusively breastfed.

At 12 months, the biologics-exposed vs nonexposed group had a significantly higher number of infants with normal ASQ-3 total scores (86 percent vs 74%; p=0.031) and normal gross motor domain scores (91 percent vs 81 percent; p=0.033).

In multivariate analysis, the odds of abnormal ASQ-3 were high among children who were born preterm (odds ratio [OR], 0.3, 95 percent confidence interval [CI], 0.1–0.6) and those born to mother with ulcerative colitis (OR, 0.5, 95 percent CI, 0.3–0.9). Other variables, including exposure to biologics in utero, showed no association with ASQ-3 scores at month 12.