Session Information
Date: Saturday, November 16, 2024
Title: SpA Including PsA – Diagnosis, Manifestations, & Outcomes Poster I
Session Type: Poster Session A
Session Time: 10:30AM-12:30PM
Background/Purpose: Only scarce data is available regarding pregnancy outcomes in early axSpA. The objective of this study was to determine (a) the factors associated with the occurrence of a clinical pregnancy during follow-up and (b) the risk factors for an unfavourable pregnancy outcome (e.g. miscarriage, medical termination or pre-term delivery) in an early axSpA population after 10 years of follow up.
Methods: Observational prospective French cohort (DESIR) with 10 years of follow-up including 381 TNFi-naïve women of reproductive age, with axSpA with less than 3 y. Study visits were scheduled every 6 months in the first two years and then yearly for up to 10 years. Data on pregnancy were collected retrospectively (before cohort inclusion) and prospectively (since inclusion) up to 10y of follow-up. Baseline characteristics were compared between nulligravidae and uni/multigravidae patients. The probability of achieving at least one pregnancy over time was estimated (Kaplan Meier). Factors associated with a clinical pregnancy occurring over follow-up and risk factors for an unfavourable pregnancy outcome (e.g. miscarriage, medical termination or pre-term delivery) were estimated by shared fraility models.
Results: Overall 724 pregnancies in 381 women occurred, before and after inclusion. After 10 years, 294 (77.1%) patients had at least one pregnancy and 96 (22.8%) had none. Multigravidae women were significantly older (37±8 vs 28 ± 7, p< 0.001) and had higher BASFI (3.5±2.4 vs 2.8±2.2, p=0.008) scores at baseline. The mean age of first pregnancy was 26.1 ±5.4 years old. One hundred and fifty three pregnancies occurred during follow up. Except for age, no factor was found to be associated with pregnancy over follow-up. Among the 107 pregnancies prospectively collected with data available on the outcome, 87 (81.3%) presented a full-term delivery, while 16 (14.9%) presented an unfavourable pregnancy outcome (8 (7.5%) and 6 (5.6%) had a miscarriage or a pre-term delivery, respectively, 2 (1.9%) had a medical abortion), 3 (2.8%) had an elective abortion, and 1 (0.9%) were pregnancies still ongoing at the end of follow-up. The probability of presenting an unfavorable outcome over the 10 years of follow up was 13% [0.1-0.2]. No factor was found to be associated with unfavourable pregnancy outcome (Table1).
|
Characteristic in the 6 months prior to pregnancy, |
Favourable outcome |
Unfavourable outcome |
p-value |
|
mean (sd) or n (p) |
|||
|
Age, years |
32.3 (4.8) |
33.1 (4.2) |
0.7 |
|
BMI, kg/m2 |
25.2 (4.4) |
26.5 (5.3) |
0.4 |
|
Tabac |
9 (10%) |
1 (6.3%) |
>0.9 |
|
BASDAI, (0-100) |
37 (21) |
45 (20) |
0.13 |
|
ASDAS CRP |
2.26 (0.95) |
2.52 (0.73) |
0.2 |
|
CRP ≥ 6 mg/L |
63 (75%) |
12 (86%) |
0.5 |
|
Arthritis |
33 (36%) |
7 (44%) |
0.6 |
|
CsDMARD use |
2 (2.3%) |
1 (6.3%) |
0.4 |
|
Orale corticosteroids use |
8 (12%) |
2 (17%) |
0.6 |
|
NSAID use |
53 (58%) |
11 (69%) |
0.4 |
|
Anti TNF alpha use |
17 (20%) |
6 (38%) |
0.2 |
Table 1 : Characteristics of patients in the 6 months prior to favourable outcome pregnancies vs. unfavourable outcome pregnancies
Conclusion: After 10 years of follow-up of 381 women with recent-onset axSpa, more than 75% had at least one pregnancy. Of all pregnancies that occurred during follow up, an unfavourable outcome was observed in less than 15% of them.
To cite this abstract in AMA style:
FRANC M, Tournadre A, Molto A. Less Than 15% Unfavourable Pregnancy Outcomes in Patients with Recent-onset Axial Spondyloarthritis: The Analysis of the 10 Years DESIR Cohort Follow-up [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/less-than-15-unfavourable-pregnancy-outcomes-in-patients-with-recent-onset-axial-spondyloarthritis-the-analysis-of-the-10-years-desir-cohort-follow-up/. Accessed .ACR Meeting Abstracts - https://acrabstracts.org/abstract/less-than-15-unfavourable-pregnancy-outcomes-in-patients-with-recent-onset-axial-spondyloarthritis-the-analysis-of-the-10-years-desir-cohort-follow-up/