Women who received pre-pregnancy combination therapy with a conventional synthetic DMARD (csDMARD), a biologic DMARD and/or glucocorticoids in any combination of at least two had a moderately increased risk of developing pre-eclampsia compared with controls. Patients did not have an increased risk of pre-eclampsia if they had no treatment or if they received monotherapy with a csDMARD, a bDMARD or a glucocorticoid. For patients with PsA, pre-pregnancy monotherapy with a csDMARD, a bDMARD or a glucocorticoid was associated with pre-eclampsia.
When stratifying the risk on the basis of treatment during pregnancy, no significant increased risk of pre-eclampsia was observed for any of the groups with rheumatic disease. A doubled pre-eclampsia risk was associated with high disease activity in patients with RA (n=756; 43%) compared with the control group. Patients with axSpA and PsA had no increased risk of pre-eclampsia, and the event numbers were low. Three patients with axSpA had pre-eclampsia, and five patients with PsA had pre-eclampsia.
Overall, this study showed that pregnant women with PsA, but not patients with axSpA, are at increased risk of pre-eclampsia. Pregnant women with RA and severe disease who have combination therapy before pregnancy and high disease activity during pregnancy also have an increased risk of developing pre-eclampsia.
Michele B. Kaufman, PharmD, BCGP, is a freelance medical writer based in New York City and a pharmacist at New York Presbyterian Lower Manhattan Hospital.
Reference
- Secher A, Hellgren K, Glintborg B, et al. Risk of pre-eclampsia and impact of disease activity and anti-rheumatic treatment in women with rheumatoid arthritis, axial spondylarthritis and psoriatic arthritis—a collaborative matched cohort study from Sweden and Denmark [abstract 1722]. Arthritis Rheumatol. 2021 Oct; 73 (suppl 10).
