A prospective French cohort study has found a stark difference in postpartum disease activity between two major inflammatory rheumatic conditions. Rheumatoid arthritis patients experienced significantly more flares after pregnancy, while spondyloarthritis activity remained stable.
Researchers analyzed data from the French multicenter GR2 cohort (2014-2022), including 94 rheumatoid arthritis patients and 124 spondyloarthritis patients. Among the rheumatoid arthritis group, 62% had at least one flare within the first 6 months postpartum, compared to 43.5% during pregnancy. In contrast, spondyloarthritis patients showed no change in flare rates, with 40.7% experiencing flares both during and after pregnancy.
Breastfeeding duration did not correlate with disease activity changes in either group. Biologic disease-modifying antirheumatic drug use was continued throughout pregnancy and postpartum in 14.3% of rheumatoid arthritis and 23.6% of spondyloarthritis patients. Among those who stopped, 55.1% of rheumatoid arthritis and 59.6% of spondyloarthritis patients restarted biologic therapy after delivery.
The findings underscore the need for enhanced postpartum monitoring for rheumatoid arthritis patients, with researchers calling for better guidance on biologic therapy continuation and reintroduction during pregnancy and the postpartum period.