Paternal IBD medication use before conception carries no excess risk of childhood infections

Fathers’ exposure to anti-inflammatory or immunosuppressive medications for inflammatory bowel disease (IBD) prior to conception does not appear to contribute to a significantly increased risk of childhood infections, a study has found.

The study used a nationwide cohort study based on Danish health registries and included all live-born singleton children born between January 1997 and February 2019 who were fathered by men with IBD.

There were 2,178 children with fathers exposed to 5-aminosalicylates (5-ASAs), 843 children with fathers exposed to thiopurines, 417 children with fathers exposed to systemic corticosteroids, and 436 children with fathers exposed to antitumour necrosis factor-α (anti-TNF-α) agents. Exposures were defined as use of medications within 3 months before conception.

Meanwhile, the unexposed cohort included 6,799 children whose fathers were not exposed to IBD medications.

In multivariable Cox regression models, the adjusted hazard ratios (aHRs) for infections within the first year of life were 0.78 (95 percent confidence interval [CI], 0.66–0.91) with paternal 5-ASAs exposure, 0.89 (95 percent CI, 0.73–1.09) with paternal thiopurines exposure, 0.95 (95 percent CI, 0.70–1.29) with paternal systemic corticosteroids exposure, and 1.17 (95 percent CI, 0.94–1.46) with paternal anti-TNF-α agents exposure compared with nonexposure.

The aHRs for infections from 1 to 3 years of life were 0.97 (95 percent CI, 0.83–1.13) in the 5-ASA group, 0.87 (95 percent CI, 0.71–1.07) in the thiopurine group, 1.25 (95 percent CI, 0.94–1.65) in the systemic corticosteroid, and 0.79 (95 percent CI, 0.60–1.03) in the anti-TNF-α agent group relative to the nonexposed group.

The present data fill an important research gap regarding paternal medication safety.