Loading ...

TOPLINE:

Pregnant women with psoriatic arthritis (PsA) were more likely to have preterm birth than those without the condition. Exposure to combination antirheumatic therapy during pregnancy and high disease load before pregnancy were identified as risk factors.

METHODOLOGY:

• Researchers aimed to estimate the risk for preterm birth and to identify related risk factors in pregnant women with PsA using data from clinical rheumatology and birth registers in Sweden, Denmark, and Norway.
• They analysed 688 singleton pregnancies resulting in deliveries after the diagnosis of PsA, which were matched with 6880 control pregnancies without PsA across different timeframes between 2006 and 2021.
• Data on antirheumatic treatment in the 9 months before and during pregnancy and on disease load were assessed.
• The primary outcome was preterm birth, defined as giving birth before 37 weeks of gestation.

TAKEAWAY:

• Preterm births occurred in 7.8% of pregnancies with PsA vs 4.5% of control pregnancies, representing an 80% higher likelihood in pregnancies with PsA (adjusted odds ratio [aOR], 1.80; 95% CI, 1.29-2.51).
• Pregnancies with PsA exposed to a combination therapy of biological disease-modifying antirheumatic drugs (bDMARDs) and conventional synthetic DMARDs and/or glucocorticoids had increased odds of preterm births (aOR, 4.44; 95% CI, 2.07-9.50).
• bDMARD monotherapy during pregnancy was not associated with increased odds of preterm births; however, the odds were highly elevated in women who discontinued bDMARDs during the first trimester (aOR, 7.24; 95% CI, 2.75-19.0).
• Women with a high disease load before pregnancy had higher odds of preterm birth than control women (aOR, 2.66; 95% CI, 1.56-4.56).

IN PRACTICE:

"[The] findings emphasise the importance of monitoring women with high PsA disease burden and additional risk factors before and during pregnancy," the authors wrote.

SOURCE:

This study was led by Anne Emilie Pape Secher, COPECARE (Copenhagen Center for Arthritis Research, Centre for Rheumatology and Spine Diseases), Copenhagen, Denmark. It was published online on October 05, 2025, in RMD Open.

LIMITATIONS:

The birth registers did not capture early pregnancy losses. The observational design may have introduced residual confounding. Substantial missing data on disease activity raised concerns about the routine monitoring of PsA during pregnancy.

DISCLOSURES:

This study received support from NordForsk, FOREUM, the Swedish Rheumatism Association, and the Danish Rheumatism Association. Several authors reported receiving research grants, speakers bureau, and consultancy fees and/or being on the steering committee of multiple pharmaceutical and healthcare companies. One author reported being a part-time employee of the Swedish Medical Products Agency.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.