A NEW study has revealed that pregnancy outcomes vary significantly among women with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondyloarthritis (SpA). The findings underscore the importance of individualised, multidisciplinary care for women with chronic inflammatory arthritis before, during, and after pregnancy.
Differences in live birth and complication rates
Researchers at Hamad General Hospital in Qatar conducted a retrospective cohort study of 189 pregnant women between 2016 and 2022 (RA = 131, SpA = 29, PsA = 29). The analysis compared maternal and neonatal outcomes across the three disease groups.
Women with spondyloarthritis (SpA) had the most favourable outcomes, including the highest live birth rate (89.7%) and the lowest rates of miscarriage and peripartum complications. By contrast, rheumatoid arthritis (RA) was associated with a higher risk of intrauterine growth restriction (31%) and pregnancy complications.
Psoriatic arthritis (PsA) showed the lowest preterm birth rate (6.9%) but the highest rate of neonatal intensive care unit (NICU) admissions (13.8%). Multivariable analysis confirmed that women with SpA had significantly higher odds of live birth and lower risks of miscarriage and low birth weight compared with RA.
Medication use and pregnancy outcomes
The study also evaluated how treatments influenced pregnancy outcomes. Sulfasalazine use was linked to a lower miscarriage risk and higher likelihood of live birth, though it was also associated with a higher rate of NICU admissions. Similarly, anti-TNF therapy increased NICU admissions, while hydroxychloroquine showed a protective effect against NICU admissions and low birth weight.
Advanced maternal age emerged as an independent risk factor for complications across all arthritis subtypes.
Implications for clinical care
According to the authors, led by Dr Samar Al Emadi, the findings highlight the need for close collaboration between rheumatologists, obstetricians, and maternal–fetal medicine specialists to optimise pregnancy outcomes.
