A new study suggests that disease-modifying antirheumatic drugs (DMARDs) may be tied to an increased risk for preterm birth or cesarean delivery for pregnant women having psoriatic arthritis (PsA).

The study, published in Arthritis & Rheumatology, noted that the risk was especially high for women with PsA who were given biologic disease-modifying antirheumatic drugs (bDMARDs). The Swedish nationwide, register-based cohort study assessed 921 pregnancies of women with PsA from 2007 through 2017. These were compared with pregnancies of 9210 women without PsA over the same period.

Among women with PsA treated in the year prior to pregnancy (n=170), 39.4% received monotherapy with a conventional synthetic DMARD (csDMARD); 24.1% were given oral corticosteroids; 15.9% received a tumor necrosis factor inhibitor (TNFi); and about 20% of women received two or more antirheumatic drugs. Among women treated during pregnancy (n=256), 153 did not receive bDMARDs. Of these, 41.8% received monotherapy with either a csDMARD or corticosteroids. Patients treated with bDMARDs received TNFi monotherapy (43.7%) or TNFi with corticosteroids (35.9%), TNFi with csDMARD (9.7%), or TNFi with csDMARD plus corticosteroids (9.7%). Women in the PsA group had higher odds of experiencing preterm birth (adjusted odds ratio, 1.69), and undergo an elective (aOR, 1.77) or emergency C-section (aOR, 1.42). Those who were given antirheumatic treatment had a greater risk for preterm birth (aOR, 2.30), and the risk was even higher for bDMARD therapy, in comparison with women without PsA (aOR, 4.49)… (Medscape)