Thiopurines (Azathioprine, Mercaptopurin) updated on 07-28-2025

Neonatal infections

id	Study   Auto Vestergaard, 2024Mahadevan, 2021Meyer a (Controls exposed to Anti-TNF), 2021Meyer a (Controls unexposed, sick), 2021Norgard, 2020Casanova, 2013Francella, 2003	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18482 R78424	Vestergaard, 2024	Neonatal Serious Infections Requiring Hospital Admission	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, sick	Adjustment: Yes Indications: Inflammatory Bowel disease (IBD)	1.70 [0.60;5.00]	-/111   -/372	-	111		ref
S12218 R45547	Mahadevan, 2021	Any infection at first year of life	3 months (or more) before pregnancy or during pregnancy excluded	prospective cohort	unexposed, sick	Adjustment: Yes Indications: Inflammatory Bowel disease (IBD)	0.90 [0.64;1.28] excluded (exposition period)	107/233   173/366	280	233		ref
S13540 R52319	Meyer a (Controls exposed to Anti-TNF), 2021	Serious infection up to 1 year (defined as infection requiring hospitalization as the primary diagnosis)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: Yes Indications: Inflammatory Bowel disease (IBD)	0.83 [0.69;1.01] excluded (control group)	-/3,392   -/3,399	-	3,392		ref
S12215 R45512	Meyer a (Controls unexposed, sick), 2021	Serious infection up to 1 year (defined as infection requiring hospitalization as the primary diagnosis)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Indications: Inflammatory Bowel disease (IBD)	0.93 [0.82;1.06]	-/3,392   -/18,954	-	3,392		ref
S6294 R17981	Norgard, 2020	Infection, any kind diagnosed in a hospital (child 0-1 year)	3 months (or more) before pregnancy or during pregnancy excluded	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Indications: Any or not specified	0.91 [0.77;1.07] excluded (exposition period)	147/1,048   164,080/1,309,961	164,227	1,048		ref
S10792 R52290	Casanova, 2013	Infections	3 months (or more) before pregnancy or during pregnancy excluded	retrospective cohort	exposed to other treatment, sick	Adjustment: No Indications: Inflammatory Bowel disease (IBD)	0.63 [0.17;2.41] C excluded (exposition period)	3/187   8/318	11	187		ref
S11066 R44832	Francella, 2003	Major or frequent infections in offspring	throughout pregnancy	retrospective cohort	unexposed, sick	Adjustment: No Indications: Inflammatory Bowel disease (IBD)	7.67 [0.99;59.57] C	2/14   2/94	4	14		ref
					Total	3 studies	1.52 [0.62;3.72]		4	3,517
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 13540