{"entity": "researcher", "timestamp": "2026-09-24T14:45:57.269Z", "family": "Kieler", "given": "Helle", "initials": "H", "orcid": "0000-0001-9338-7133", "affiliations": ["Centre for Pharmacoepidemiology, Department of Medicine Solna and Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden."], "links": {"self": {"href": "https://publications-affiliated.scilifelab.se/researcher/831da95a6b2f4a9b9e29aed574219101.json"}, "display": {"href": "https://publications-affiliated.scilifelab.se/researcher/831da95a6b2f4a9b9e29aed574219101"}}, "publications": [{"entity": "publication", "iuid": "d413d5d0e7b84b61a960fa93b787591a", "links": {"self": {"href": "https://publications-affiliated.scilifelab.se/publication/d413d5d0e7b84b61a960fa93b787591a.json"}, "display": {"href": "https://publications-affiliated.scilifelab.se/publication/d413d5d0e7b84b61a960fa93b787591a"}}, "title": "Use of sildenafil and other phosphodiesterase type 5 inhibitors among pregnant women in Scandinavia.", "authors": [{"family": "Cesta", "given": "Carolyn E", "initials": "CE", "orcid": "0000-0001-5759-9366", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/35e1b896082549c2b69ead371bf4e3a8.json"}}, {"family": "Segovia Chac\u00f3n", "given": "Silvia", "initials": "S", "orcid": "0000-0003-0210-5829", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/2e63ae649a0e4a18847b5e19d73ea48b.json"}}, {"family": "Engeland", "given": "Anders", "initials": "A", "orcid": "0000-0001-5620-9207", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/fa92583833b8407392fef0584366c87e.json"}}, {"family": "Broe", "given": "Anne", "initials": "A", "orcid": "0000-0002-4149-8808", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/9ff2659b76694a548fb6a84225f90885.json"}}, {"family": "Damkier", "given": "Per", "initials": "P", "orcid": "0000-0003-0591-7187", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/3220b6c562f2497f9122594f270ba2ab.json"}}, {"family": "Furu", "given": "Kari", "initials": "K", "orcid": "0000-0003-2245-0179", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/f00c9192b2a642869c13e93ca5526147.json"}}, {"family": "Kieler", "given": "Helle", "initials": "H", "orcid": "0000-0001-9338-7133", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/831da95a6b2f4a9b9e29aed574219101.json"}}, {"family": "Karlsson", "given": "P\u00e4r", "initials": "P", "orcid": "0000-0002-7177-1713", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/9177884596f74f758d9a3cbfc472a8e0.json"}}], "type": "journal article", "published": "2021-11-00", "journal": {"title": "Acta Obstet Gynecol Scand", "issn": "1600-0412", "volume": "100", "issue": "11", "pages": "2111-2118", "issn-l": null}, "abstract": "For phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, the only approved indication in women is for pulmonary arterial hypertension. These drugs are increasingly being proposed and tested for treatment of female infertility and complications in pregnancy. However, the extent of use of PDE5 inhibitors in the general pregnant population over the last decades is unknown. Therefore, we conducted a descriptive cohort study using data from the population health registers in the Scandinavian countries.\n\nBy linking the Medical Birth Registers and the Prescribed Drug Registers in Denmark (1997-2017), Norway (2004-2017), and Sweden (2006-2016), women with filled prescriptions of PDE5 inhibitors in outpatient settings in the 90 days before the date of last menstrual period and/or during pregnancies were identified. With additional linkage to the National Patient Registers, information on maternal, pregnancy, and infant characteristics, co-morbidities, and co-medication was collected and described.\n\nAmong over 3 million singleton pregnancies, only 77 were pregnancies in women who had at least one filled prescription of a PDE5 inhibitor within the 90 days before the start of pregnancy to delivery. Prescription fills most often occurred before the last menstrual period and in the first trimester, with very few occurring later in pregnancy. Sildenafil was the most used PDE5 inhibitor. Among pregnant women using PDE5 inhibitors, 44% were 35 years of age or older, eight had a cardiovascular diagnosis, and three specifically had a diagnosis of pulmonary arterial hypertension. Among the infants born to mothers using PDE5 inhibitors, nine were born preterm, six were small-for-gestational age, five had an Apgar score at 5 minutes below 8, 18 were admitted to the Neonatal Intensive Care Unit, and eight had respiratory and cardiovascular conditions.\n\nFew women used PDE5 inhibitors in outpatient settings before or during pregnancy in the Scandinavian countries in the last decades. Only a small proportion had a diagnosis for pulmonary arterial hypertension, suggesting off-label use in the remaining users. Use was predominantly in mothers over age 35 years. The safety of fetal exposure to sildenafil and other PDE5 inhibitors in pregnancy has not been established. As maternal age continues to increase and additional uses of PDE5 inhibitors are investigated, the safety of these drugs in pregnancy should be thoroughly evaluated.", "doi": "10.1111/aogs.14251", "pmid": "34453753", "labels": [], "xrefs": [], "notes": [], "created": "2026-09-23T13:11:17.932Z", "modified": "2026-09-23T13:11:18.147Z"}, {"entity": "publication", "iuid": "eb86ffc075d6438fad7c08928e821b3a", "links": {"self": {"href": "https://publications-affiliated.scilifelab.se/publication/eb86ffc075d6438fad7c08928e821b3a.json"}, "display": {"href": "https://publications-affiliated.scilifelab.se/publication/eb86ffc075d6438fad7c08928e821b3a"}}, "title": "Anti-TNF treatment during pregnancy and birth outcomes: A population-based study from Denmark, Finland, and Sweden.", "authors": [{"family": "Br\u00f6ms", "given": "Gabriella", "initials": "G", "orcid": "0000-0002-2423-1968", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/ba30331e2aad4a8b8d7ba6a0578193b7.json"}}, {"family": "Kieler", "given": "Helle", "initials": "H", "orcid": "0000-0001-9338-7133", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/831da95a6b2f4a9b9e29aed574219101.json"}}, {"family": "Ekbom", "given": "Anders", "initials": "A", "orcid": "0000-0001-6674-5003", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/3e61ab107fe347aebb2c7bb29e3fb795.json"}}, {"family": "Gissler", "given": "Mika", "initials": "M", "orcid": "0000-0001-8254-7525", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/8d4fbc591a0547beaaf224856e96949f.json"}}, {"family": "Hellgren", "given": "Karin", "initials": "K", "orcid": "0000-0001-7149-0973", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/d7f3861a3f14424785315e5d4d3e330e.json"}}, {"family": "Lahesmaa-Korpinen", "given": "Anna-Maria", "initials": "AM", "orcid": "0000-0003-1062-2893", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/6530a707032341d09ae43c794c54e84a.json"}}, {"family": "Pedersen", "given": "Lars", "initials": "L", "orcid": "0000-0002-9341-3888", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/fa1b528444da46a89a923e3e3eb87280.json"}}, {"family": "Schmitt-Egenolf", "given": "Marcus", "initials": "M", "orcid": "0000-0002-3858-8474", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/8656f121cd504cddaf2cd658fbeed9d8.json"}}, {"family": "S\u00f8rensen", "given": "Henrik T", "initials": "HT", "orcid": "0000-0003-4299-7040", "researcher": {"href": "https://publications-affiliated.scilifelab.se/researcher/66671606c59445cb967124edb7827eda.json"}}, {"family": "Granath", "given": "Fredrik", "initials": "F"}], "type": "journal article", "published": "2020-03-00", "journal": {"title": "Pharmacoepidemiol Drug Saf", "issn": "1099-1557", "volume": "29", "issue": "3", "pages": "316-327", "issn-l": null}, "abstract": "To study the risk of preterm birth, caesarean section, and small for gestational age after anti-tumor necrosis factor agent treatment (anti-TNF) in pregnancy.\n\nPopulation-based study including women with inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and psoriasis, and their infants born 2006 to 2013 from the national health registers in Denmark, Finland, and Sweden. Women treated with anti-TNF were compared with women with nonbiologic systemic treatment. Adalimumab, etanercept, and infliximab were compared pairwise. Continuation of treatment in early pregnancy was compared with discontinuation. Odds ratios with 95% confidence intervals were calculated in logistic regression models adjusted for country and maternal characteristics.\n\nAmong 1 633 909 births, 1027 infants were to women treated with anti-TNF and 9399 to women with nonbiologic systemic treatment. Compared with non-biologic systemic treatment, women with anti-TNF treatment had a higher risk of preterm birth, odds ratio 1.61 (1.29-2.02) and caesarean section, 1.57 (1.35-1.82). The odds ratio for small for gestational age was 1.36 (0.96-1.92). In pairwise comparisons, infliximab was associated with a higher risk of severely small for gestational age for inflammatory joint and skin diseases but not for inflammatory bowel disease. Discontinuation of anti-TNF had opposite effects on preterm birth for inflammatory bowel disease and inflammatory joint and skin diseases.\n\nAnti-TNF agents were associated with increased risks of preterm birth, caesarean section, and small for gestational age. However, the diverse findings across disease groups may indicate an association related to the underlying disease activity, rather than to agent-specific effects.", "doi": "10.1002/pds.4930", "pmid": "32020767", "labels": [], "xrefs": [], "notes": [], "created": "2026-09-23T08:32:34.342Z", "modified": "2026-09-23T08:32:34.950Z"}]}