New Insights into Pregnancy Outcomes and Maternal-Fetal Health in Rheumatic Diseases Save

At ACR Convergence 2025, the American College of Rheumatology presents new research illuminating critical challenges and advances in pregnancy outcomes for women living with rheumatic diseases, including axial spondyloarthritis, antiphospholipid syndrome, and lupus. These studies offer important insights into obstetric and neonatal risks, biomarkers predictive of fetal complications, and emerging therapies to improve maternal and fetal health.

Obstetric and Neonatal Complications in Axial Spondyloarthritis
A population-based matched cohort study examined pregnancy outcomes in women with axial spondyloarthritis. Findings revealed increased rates of certain obstetric complications compared to controls including severe maternal morbidity (SMM), underscoring the need for specialized monitoring and multidisciplinary care in this population to optimize pregnancy health and outcomes.

Predictive Biomarkers for Fetal Atrioventricular Block
Using advanced Olink proteomics analysis, another study (Abstract 0853) identified macrophage pro-inflammatory proteins in maternal sera that predict fetal atrioventricular (AV) block independent of maternal health status. These novel biomarkers may enable earlier identification and intervention to prevent serious fetal cardiac complications, improving neonatal prognosis.

Certolizumab Pegol to Prevent Adverse Pregnancy Outcomes in Antiphospholipid Syndrome
An ongoing Phase 2 trial (IMPACT; Abstract 0855) is evaluating certolizumab pegol, a biologic therapy, to prevent adverse pregnancy outcomes in patients with antiphospholipid syndrome and lupus anticoagulant. Preliminary recruitment results suggest this targeted therapy could substantially reduce pregnancy loss and complications, addressing a critical unmet need in this high-risk group.

“These studies reflect a vital commitment to improving reproductive health outcomes for women living with rheumatic diseases,” said Sinead Macguire MD, rheumatologist at Our Lady's Hospital Navan, Ireland and lead researcher on the Obstetric and Neonatal Complications in Women living with Axial Spondyloarthritis: a population-based, matched cohort study. “Understanding the complex interactions between maternal disease, biomarkers, and therapeutic options will drive safer pregnancies and healthier babies.”