Project 458924

Chronic inflammatory diseases, including rheumatoid arthritis and Crohn's disease, affect many Canadians. Women of childbearing age are mainly diagnosed. The main way to manage these diseases is with drugs. A common drug used to treat these conditions is tumour necrosis factor inhibitors (TNFi). These drugs reduce flares, but there are concerns that TNFi may suppress the immune system and reduce the body's ability to fight infection. However, there is minimal data on infection risk in pregnant women taking TNFi. My research looks at the risk of infections related to the use of TNFi in pregnant women. I further want to determine the consequent threat to their babies. I will use a large health records database to study a group of pregnant women with chronic inflammatory diseases. I will measure their risk of infection during pregnancy and after giving birth. To do this, I will compare women taking TNFi with those who are not. As these drugs are known to pass from mother to child through the placenta, my next aim will focus on the children. Babies of women taking TNFi during pregnancy may also have reduced immune responses. This can last until they are 6 months old. Thus, I will study the risk of infections in these babies during their first year of life. This risk may be greater in children of mothers who took TNFi if they receive certain routine vaccines before the drugs have left their bodies. More complications can happen because the child struggles to fight infections. This may lead to more common childhood infections. Knowing the risks of infection from TNFi exposure in mothers and their babies is important for delivering safe care to these patients. My work will provide much-needed data to help advise medical guidelines. It will also make sure that women taking TNFi during pregnancy have better outcomes. Overall, my project can help improve the health of pregnant women and their babies by reducing infections in these at-risk groups.