TNF and preeclampsia: However, a large cohort study by Adomi et al. (2024), which included more than 4.3 million pregnancies, showed that the use of TNF-α inhibitors in the first and second trimesters does not reduce the risk of early or late preeclampsia (RR 1.25 [0.93–1.67] and RR 0.99 [0.81–1.22], respectively) [18].