Good Pregnancy Outcomes for DMARD Exposed JIA Patients Save

A study of pregnancy outcomes in 98 women with juvenile idiopathic arthritis (JIA) who were exposed to DMARDs shows no increased risk of major adverse pregnancy outcomes.

A total of 152 pregnancies in 98 women with JIA and 39 pregnancies involving 21 male patients as partners were reviewed. The majority had a polyarticular JIA (61%). The average age at first pregnancy was 24.1 years, and their mean disease duration was 13.8 years.

Patients were selected because of their DMARD exposure, which averaged to 9.5 years of exposure, with 90% having received biologics before. Half of the pregnancies occurred during DMARD exposure, mostly with etanercept.

There were no significant differences in pregnancy outcomes when comparing DMARD-exposed and DMARD-unexposed pregnancies.  Adverse pregnancy outcomes (spontaneous abortion-13.1% or congenital anomaly-3.6%) occurred at rates equal to or below expected background rates.

Rates of premature birth (12.3%) and cesarean section (37.7%) were slightly above those in the German birthing population. 

Young adults with JIA, or their spouses, who are exposed to DMARD therapy do not appear to be at annincreased risk of adverse pregnancy outcomes.