BACKGROUND AND PURPOSE:

• Studies on pregnancies outcomes in women with psoriatic arthritis are limited and generally have small samples sizes
• Studies on rheumatoid arthritis and related disorders have reported increased risk for
  • Preterm birth | SGA | Preeclampsia | Cesarean delivery
• Remaeus et al. (BJOG, 2019) sought to determine maternal and infant outcomes specific to psoriatic arthritis

METHODS:

• Nationwide cohort study (Swedish)
• Participants
  • Women with singleton pregnancies
• Exposures
  • Pregnancies affected with psoriatic arthritis
  • Pregnancies not complicated by psoriatic arthritis
• Data analysis
  • Adjustments made for maternal factors and calendar year of birth
• Primary outcomes
  • Maternal and infant pregnancy outcomes

RESULTS:

• 41,485 pregnancies were included
  • 541 psoriatic arthritis pregnancies | 40,944 non-psoriatic arthritis pregnancies
  • Women with psoriatic arthritis were more likely to be obese, smokers, had IBD, ankylosing spondylitis and rheumatoid arthritis
• In pregnancies with psoriatic arthritis, there was an increased risk of
  • Preterm birth: adjusted odds ratio (OR) 1.63 (95% CI, 1.17 to 2.28)
  • Elective cesarean delivery: aOR 1.47 (95% CI, 1.10 to 1.97)
  • Emergency caesarean delivery: aOR 1.43 (95% CI, 1.08 to 1.88)
• Risk for preterm birth was increased for first pregnancies
  • Psoriatic arthritis: 10.7%
  • Non- psoriatic arthritis: 5.7%
  • aOR 1.90 (95% CI 1.33–2.72)
• In the psoriatic arthritis pregnancy group there were no differences found for the following
  • Preeclampsia
  • Stillbirth
  • Other adverse infant outcomes

CONCLUSION:

• Authors recognize limitations of the study including lack of data on severity, which does impact adverse outcomes in the context of other arthritis diseases
• Women with psoriatic arthritis can be reassured that most will have uncomplicated births with limited adverse outcome
• However, compared to women without psoriatic arthritis, there is an increased risk for preterm birth and cesarean delivery, consistent with other inflammatory arthritis diseases like rheumatoid arthritis

Learn More – Primary Sources:

Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study

Related ObG Topics:

Does Contraceptive Use and/or Breastfeeding Impact Risk of Rheumatoid Arthritis?

Does Timing of Introduction of Allergenic Food Affect Risk of Allergic or Autoimmune Disease in Infants

Does Physical Activity During Pregnancy Reduce Risk for Preterm Birth?

Antenatal Corticosteroids – When to Administer?