Evaluation of pregnancy outcomes in patients with spondyloarthritis compared to the general population: results from a French national prospective and matched study

Sabrina Hamroun¹, Grégoire Martin de Frémont², Nathalie Costedoat-Chalumeau³, Marion Couderc⁴, René-Marc Flipo⁵, Jérémie Sellam⁶, Christophe Richez⁷, Rakiba Belkhir², Laure Gossec⁸, Hubert Marotte⁹, Emmanuel Dernis¹⁰, Aline Frazier-Mironer¹¹, Elisabeth Gervais¹², Cédric Lukas¹³, Valérie Devauchelle-Pensec¹⁴, Alban Deroux¹⁵, Véronique Le Guern¹⁶, Gaëlle Guettrot-Imbert¹⁶, Nathalie Lelong¹⁷, Emmanuelle Pannier¹⁸, Loic Sentilhes¹⁹, Camille Le Ray²⁰, Raphaèle Seror²¹, Anna Molto²²; GR2 and the ENP2021 Study Groups

Affiliations

¹ Rheumatology Department, NOVO Hospital, Pontoise, France.
² Rheumatology Department, Kremlin-Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
³ Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France; Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France.
⁴ Rheumatology Department, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France; IMOST team-INSERM (1240), Clermont Auvergne University, Clermont-Ferrand, France.
⁵ Rheumatology Department, Salengro Hospital, Lille University Hospital, Lille, France.
⁶ Rheumatology Department, Sorbonne University, CRSA INSERM UMRS8938, Saint-Antoine University Hospital, AP-HP Centre, Paris, France.
⁷ Rheumatology Department, Bordeaux University Hospital, Bordeaux, France.
⁸ Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Team Pepites, Paris, France; AP-HP, Pitié Salpêtrière Hospital, Rheumatology Department, Paris, France.
⁹ Université Jean Monnet, Service de Rhumatologie, CHU Saint-Etienne, INSERM, Mines Saint Etienne, SAINBIOSE U1059, Saint Etienne, France.
¹⁰ Rheumatology Department, Le Mans Hospital, Le Mans, France.
¹¹ Rheumatology Department, Lariboisière University Hospital, Paris, France.
¹² Rheumatology Department, University Hospital and LITEC UR15560 Poitiers, France.
¹³ Rheumatology Department, Montpellier University Hospital, Montpellier, France.
¹⁴ Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares du Nord-Ouest (CERAINOM), Brest University Hospital, Brest, France.
¹⁵ Internal Medicine Department, Grenoble University Hospital, Grenoble, France.
¹⁶ Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France.
¹⁷ University of Paris, INSERM Obstetrical Perinatal and Pediatric Epidemiology Research Team, Paris, France.
¹⁸ Port-Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU Préma, Paris, France.
¹⁹ Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
²⁰ Université Paris Cité, Institut Santé des femmes, U1153, Centre of Research In Epidemiology and Statistics (CRESS), Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOpé), INSERM, INRAE, Paris, France; Université Paris-Saclay, UVSQ, INSERM CESP U1018, Gustave Roussy, Villejuif, France.
²¹ Université Paris-Saclay, UVSQ, INSERM CESP U1018, Gustave Roussy, Villejuif, France.
²² Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France; Université Paris Cité, UFR Médecine, Paris, France; Rheumatology Department, Bichat Hospital, AP-HP Nord, Paris, France. Electronic address: anna.molto@aphp.fr.

PMID: 41241656
DOI: 10.1016/j.ard.2025.10.024

Free article

Evaluation of pregnancy outcomes in patients with spondyloarthritis compared to the general population: results from a French national prospective and matched study

Sabrina Hamroun et al. Ann Rheum Dis. 2025.

Free article

. 2025 Nov 14:S0003-4967(25)04511-X.

doi: 10.1016/j.ard.2025.10.024. Online ahead of print.

Authors

Affiliations

¹ Rheumatology Department, NOVO Hospital, Pontoise, France.
² Rheumatology Department, Kremlin-Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
³ Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France; Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France.
⁴ Rheumatology Department, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France; IMOST team-INSERM (1240), Clermont Auvergne University, Clermont-Ferrand, France.
⁵ Rheumatology Department, Salengro Hospital, Lille University Hospital, Lille, France.
⁶ Rheumatology Department, Sorbonne University, CRSA INSERM UMRS8938, Saint-Antoine University Hospital, AP-HP Centre, Paris, France.
⁷ Rheumatology Department, Bordeaux University Hospital, Bordeaux, France.
⁸ Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Team Pepites, Paris, France; AP-HP, Pitié Salpêtrière Hospital, Rheumatology Department, Paris, France.
⁹ Université Jean Monnet, Service de Rhumatologie, CHU Saint-Etienne, INSERM, Mines Saint Etienne, SAINBIOSE U1059, Saint Etienne, France.
¹⁰ Rheumatology Department, Le Mans Hospital, Le Mans, France.
¹¹ Rheumatology Department, Lariboisière University Hospital, Paris, France.
¹² Rheumatology Department, University Hospital and LITEC UR15560 Poitiers, France.
¹³ Rheumatology Department, Montpellier University Hospital, Montpellier, France.
¹⁴ Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares du Nord-Ouest (CERAINOM), Brest University Hospital, Brest, France.
¹⁵ Internal Medicine Department, Grenoble University Hospital, Grenoble, France.
¹⁶ Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France.
¹⁷ University of Paris, INSERM Obstetrical Perinatal and Pediatric Epidemiology Research Team, Paris, France.
¹⁸ Port-Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU Préma, Paris, France.
¹⁹ Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
²⁰ Université Paris Cité, Institut Santé des femmes, U1153, Centre of Research In Epidemiology and Statistics (CRESS), Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOpé), INSERM, INRAE, Paris, France; Université Paris-Saclay, UVSQ, INSERM CESP U1018, Gustave Roussy, Villejuif, France.
²¹ Université Paris-Saclay, UVSQ, INSERM CESP U1018, Gustave Roussy, Villejuif, France.
²² Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France; Université Paris Cité, UFR Médecine, Paris, France; Rheumatology Department, Bichat Hospital, AP-HP Nord, Paris, France. Electronic address: anna.molto@aphp.fr.

PMID: 41241656
DOI: 10.1016/j.ard.2025.10.024

Abstract

Objectives: The aim of the study was to determine the frequency of adverse pregnancy outcomes in women with spondyloarthritis (SpA) in comparison to controls from the French general population, and to identify factors associated with these adverse pregnancy outcomes.

Methods: This French prospective multicentre cohort study included pregnant women with SpA (both axial and peripheral) according to their treating rheumatologist between December 2015 and June 2021. Maternal characteristics, disease activity, treatments, and pregnancy outcomes were analysed. Outcomes of pregnancies in women with SpA were compared to that of matched (1:4) general population women from the 2016 and 2021 French National Perinatal Surveys, including pregnancy, neonatal, and maternal outcomes. For adverse pregnancy outcomes that are significantly more frequent in patients with SpA, logistic regression analysis was performed to identify potential risk factors.

Results: A total of 135 SpA pregnancies in 124 women were analysed: they have a mean age of 32.1 years, a mean disease duration of 6.3 years, and 50.4% were nulliparous. Small for gestational age (SGA) was the most common adverse pregnancy outcome and occurred more frequently in women with SpA compared to controls (17.4% vs 9.8%, odds ratios = 1.94, 95% CI 1.09-3.39). Other adverse pregnancy outcomes rates, including preterm birth and caesarean delivery, were comparable to the general population. No predictor of SGA was identified in women with SpA.

Conclusions: In this contemporary cohort, compared to the general population, SpA was associated with a higher risk of SGA, but no other adverse pregnancy outcomes, providing reassurance for most pregnant women with SpA.

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Evaluation of pregnancy outcomes in patients with spondyloarthritis compared to the general population: results from a French national prospective and matched study

Affiliations

Evaluation of pregnancy outcomes in patients with spondyloarthritis compared to the general population: results from a French national prospective and matched study

Authors

Affiliations

Abstract

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