Spondyloarthritis & psoriatic arthritis
Temporal trends in adverse pregnancy outcomes in axial spondyloarthritis in Sweden: a cohort study
Authors' conclusion
In view of remaining concerns regarding safety of the use of biological DMARDs during pregnancy, we saw a reassuring trend in which pregnancy outcomes improved over time in the axial spondyloarthritis group, concurrent with increased use of biological DMARDs.
Study context
- Population
- Births in Sweden between April 1, 2007, and Dec 31, 2020, to women with axSpA and matched general population comparators (Medical Birth Register linked to other registers)births
- Participants
- 1,580 vs 15,792
- Exposure
- Births in women with axSpA vs general population comparator births
- axSpAn = 1,580
- Comparatorsn = 15,792reference
- Outcome
- Relative risks of adverse pregnancy outcomes
Methodological detailsmatched 1:10 on year of delivery, maternal age, and parity, modified Poisson regression
- Matched 1:10 on year of delivery, maternal age, and parity
- Modified Poisson regression
Main finding
As reported in the abstract
Adverse pregnancy outcomes
Each group vs comparatorsEstimate (95% CI)
axSpA
RR (preterm birth) 1.43(1.13–1.80)
axSpA
RR (pre-eclampsia) 1.44(1.08–1.92)
axSpA
RR (elective caesarean delivery) 1.59(1.37–1.84)
axSpA
RR (serious infant infection) 1.29(1.05–1.59)
Observational data: associations, not effects.
Further findings
Temporal trends in axSpA over the study period
- Risks of preterm birth, infant infection, and caesarean delivery decreased annually
- around 0.5 percentage points
- Use of TNFi during pregnancy increased
Original publication
Temporal trends in adverse pregnancy outcomes in axial spondyloarthritis in Sweden: a cohort study. Lancet Rheumatol. Published 30 January 2023. doi:10.
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