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Planning, Management Key to Positive Pregnancy Outcomes in axSpA
Researchers who conducted pooled data analysis of pregnancy registries in rheumatology found that women with axial spondyloarthritis (axSpA) who were treated with tumor necrosis factor inhibitors (TNFi), received preconception counseling, and whose disease was controlled through careful management had successful outcomes on a par with the population as a whole.
Authors of the prospective study, published in Annals of Rheumatic Diseases, analyzed data from 4 registries of 332 pregnancies of 304 women with axSpA who fulfilled Assessment of SpondyloArthritis International Society (ASAS) classification criteria. The investigators reviewed records of systemic inflammation, disease activity, and treatment patterns with TNFi before, during, and after pregnancy, and calculated the rates of adverse pregnancy outcomes.
Most patients received preconception counselling (78.4%). Prior to pregnancy, 53% received TNFi treatment, while 27.5% were treated in the first trimester and 21.4% in third trimester. Pregnancy and neonatal outcomes were favorable, with a rate of 98.8% for live birth; rates for pre-eclampsia (2.2%), preterm birth (4.9%), low birth weight (3.1%), and small for gestational age (9.5%) were largely within the expected rates for the general population. These patients had Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores below 4 at all time points.
“Pooled rates of most outcomes were better than what had been reported in the literature and within expected rates of those reported for the general population,” the authors wrote. “Preconception counseling, planned pregnancies, and a tight management in expert centers applying a tailored treatment approach may have contributed to the favorable pregnancy outcomes.”
—Rebecca Mashaw
Reference:
Meissner Y, Strangfeld A, Molto A, et al. Pregnancy and neonatal outcomes in women with axial spondyloarthritis: pooled data analysis from the European Network of Pregnancy Registries in Rheumatology (EuNeP). Ann Rheum Dis. Published online first: August 12, 2022.
