Skip to main content
SMFM 2026 Pregnancy Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared outside of the session
Faculty have requested this content not be shared outside of the session
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
Poster Icons
Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Perinatal Mental Health

Poster Session 3

(983) Postpartum Mental Health Outcomes in women prescribed Tumor Necrosis Factor Alpha inhibitors

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
Several studies explored improved depression symptoms in non-pregnant individuals using TNFα inhibitors (TNFαi); however, data addressing postpartum mental health outcomes in TNFαi users are limited. We aimed to investigate mental health outcomes in postpartum mothers following exposure to TNFαi from 1 year preconception to early pregnancy compared to non-users or conventional synthetic disease modifying antirheumatic drugs (csDMARDs) exposure.   

Study Design:
We queried the TriNetX U.S Collaborative network with 71 healthcare organizations for deliveries of women with psoriasis, inflammatory bowel diseases, rheumatoid arthritis, ankylosing spondylitis, or juvenile arthritis aged ≥ 18 years from 11/6/2012 to 12/31/2024. The TNFαi group was defined as those exposed to etanercept, adalimumab, adalimumab, infliximab, certolizumab, or golimumab within 1 year preconception to 20-week gestation. Two control groups: 1) non-users; 2) active comparators: sulfasalazine, azathioprine, hydroxychloroquine, and mesalamine, were defined. Patients were followed up from 1 day after delivery (index date) up to 1 year for these outcomes: postpartum depression or mood disturbance, anxiety, bipolar or obsessive-compulsive disorder, post-traumatic stress disorder, or suicidal ideation/suicidality. Risk ratios (RR) and 95% confidence intervals (CI) were derived by comparing the outcome risks of TNFαi group that were 1:1 propensity-score matched (PSM) to controls by demographics, comorbidities, substance use, immunomodulators, healthcare behavior, and BMI. We assessed both total (including recurrent and new-onset) and new-onset diagnoses for each outcome. 

Results:
Compared to non-users (Fig. 1) and csDMARDs users (Fig. 2), the TNFαi cohort had lower total rates of bipolar disorder diagnoses (RR 0.55, 95% CI 0.31-0.96) but did not show any significant differences in other postpartum mental health outcomes for both total and new onset cases. 

Conclusion:
TNFαi exposure from 1-year prior pregnancy to early second trimester was not associated with adverse mental health outcomes in the post-partum period.