{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:09:48Z","timestamp":1778292588265,"version":"3.51.4"},"reference-count":85,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>We aimed to assess the safety of advanced therapies, excluding tumor necrosis factor inhibitors (anti-TNFs), for the treatment of immune-mediated inflammatory diseases (IMIDs), on pregnancy and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Analysis<\/jats:title>\n                    <jats:p>We performed a systematic review and meta-analysis. Study selection and data extraction were conducted independently by two reviewers. Primary outcomes included live births, major congenital malformations (MCMs), miscarriages, and stillbirths. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated using GRADE. Meta-analyses of prevalence and odds ratios (ORs) comparing advanced therapies with anti-TNFs were conducted using fixed and random effect models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 14\u2009661 manuscripts screened, 49 studies met the inclusion criteria: eight cohorts, nine case series, and 32 case reports. Most cohort studies were at a critical risk of bias. The majority of the available data related to ustekinumab (1324 exposed offspring) and vedolizumab (585 exposed offspring) whereas data on other biologics and JAK inhibitors were very limited. Pregnancies exposed to biologics had a pooled prevalence of 82.43% for live births, 0.55% for MCMs, 8.16% for miscarriage, and 0.00% for stillbirths. No significant differences in adverse pregnancy or neonatal outcomes were observed compared with women exposed to anti-TNFs. Overall, the level of evidence was very low, due largely to reliance on small observational studies and case reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence does not suggest an increased risk of adverse pregnancy or neonatal outcomes with advanced therapies for IMIDs. However, larger, high-quality studies are needed, and these findings should be interpreted as hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag045","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:37:58Z","timestamp":1774957078000},"source":"Crossref","is-referenced-by-count":0,"title":["Safety of advanced therapies during pregnancy in women with immune-mediated inflammatory diseases: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"20","author":[{"given":"Ophelie","family":"Pingeon","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, \u00c9quipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de R\u00e9f\u00e9rence sur les Agents T\u00e9ratog\u00e8nes (CRAT) , 75013, Paris,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0452-3218","authenticated-orcid":false,"given":"Nathan","family":"Grellier","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Saint-Antoine Hospital, Assistance Publique-H\u00f4pitaux de Paris APHP , Paris, 75012,","place":["France"]},{"name":"Centre de Recherche Saint-Antoine, CRSA, AP-HP, Sorbonne Universite, INSERM , Paris, \u00cele-de-France, 75012,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00e9n\u00e9dicte","family":"Coulm","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, \u00c9quipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, D\u00e9partement de Sant\u00e9 Publique, Centre de R\u00e9f\u00e9rence sur les Agents T\u00e9ratog\u00e8nes (CRAT) , 75013, Paris,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delphine","family":"Beghin","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Sant\u00e9 Publique, AP-HP Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Centre de R\u00e9f\u00e9rence sur les Agents T\u00e9ratog\u00e8nes (CRAT) , Paris, 75013,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Altman Clinical & Translational Research Institute, University of California , San Diego, La Jolla, 92037,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Chasset","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Sorbonne Universit\u00e9, AP-HP, Service de Dermatologie et Allergologie, H\u00f4pital Tenon, INSERM U1135, CIMI , Paris, 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Molecular Prediction of Inflammatory Bowel Disease, Aalborg University , Copenhagen, 9000,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Restellini","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Geneva , Geneva, 1205,","place":["Switzerland"]},{"name":"Inflammatory Bowel Disease Center, Division of Gastroenterology, H\u00f4pital de la Tour , Geneva, 1217,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agn\u00e8s","family":"Dechartres","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, \u00c9quipe PEPITES, AP-HP, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re , Paris, 75013,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Kirchgesner","sequence":"additional","affiliation":[{"name":"Department of 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