Women with psoriatic arthritis are nearly 70 percent more likely to give birth prematurely and 42 percent more likely to require a C-section, compared to those without PsA, a new study found. Pregnancy-associated risks were higher among those being treated for more severe PsA. The research was published Oct. 20 in the journal Arthritis & Rheumatology.
Psoriatic arthritis is a chronic inflammatory disease that causes joint pain, swelling, and stiffness. Up to 30 percent of people with psoriasis may develop PsA as well.
In the Sweden-based study, researchers collected data — spanning 2007 through 2017 — from 921 pregnant women with psoriatic arthritis. Their information was compared with data from 9,210 women without the condition.
The study authors found that women with PsA were:
However, PsA did not increase a woman’s risk of other potential pregnancy problems, including preeclampsia, hypertension (high blood pressure), gestational diabetes, or abnormal birth weight of the baby.
Researchers also looked at whether PsA treatments could affect pregnancy outcomes. About half of the women with PsA received treatments during pregnancy, or within one year of becoming pregnant. The treatments included corticosteroids, conventional disease-modifying antirheumatic drugs (DMARDs), and biologics.
Women who were using PsA treatments were more likely to give birth prematurely or to undergo a C-section. In particular, using biologics led to the highest risk. Women using biologic medications were:
The study authors didn’t think that the PsA treatments themselves led to problems during pregnancy. Rather, they hypothesized that women who needed treatments were more likely to have severe PsA, and severe disease is what leads to a higher risk of pregnancy complications.
The authors concluded, “All women with PsA, regardless of antirheumatic treatment, should be counselled about pregnancy outcomes and receive individualized monitoring during pregnancy.”