Murad GEZER, Ümit TAŞDEMİR, Sevdenur YİĞİT, Halise Hande GEZER, Sevtap ACER KASMAN, Özlem PEHLİVAN
Anatolian Current Medical Journal - 2026;8(1):146-152
Aims: To evaluate obstetric and neonatal outcomes in women with psoriatic arthritis (PsA) by comparing pregnancies before and after diagnosis, as well as with healthy controls, with a focus on disease activity, treatment exposure, and flares Methods: This retrospective cross-sectional study included 227 pregnancies from 85 women with PsA and 100 pregnancies from 46 healthy controls. Maternal and neonatal outcomes were assessed, including preeclampsia, gestational hypertension, gestational diabetes, cesarean delivery, preterm birth, small for gestational age (SGA), congenital anomalies, and neonatal intensive care unit (NICU) admissions. Disease activity and flares during pregnancy were recorded. Logistic regression analyses were performed to identify predictors of composite adverse maternal and neonatal outcomes. Results: Among PsA pregnancies, 161 (71%) occurred before and 66 (29%) after diagnosis. Maternal age at conception was higher post-diagnosis, and these pregnancies showed increased rates of cesarean delivery (60.4% vs. 16.9% and 14.5%, p<0.001), preeclampsia (11.3% vs. 0.7%, p<0.001), gestational diabetes (11.3% vs. 2.9%, p=0.03), and gestational hypertension (11.3% vs. 7.4% and 2.4%, p=0.03). Composite adverse maternal outcomes were more frequent after PsA diagnosis compared with both pre-diagnosis pregnancies and controls. For neonatal outcomes, SGA was significantly more common after diagnosis (17% vs. 6.6% and 2.4%, p=0.02 and p=0.002), and NICU admissions were increased compared with pre-diagnosis pregnancies (18.9% vs. 6.6%, p=0.01). Logistic regression identified advanced maternal age as an independent predictor of adverse maternal outcomes, whereas no independent predictors were found for neonatal outcomes. Conclusion: In pregnancies with PSA, adverse maternal outcomes are more frequent, especially after diagnosis, whereas neonatal outcomes are generally comparable to control groups, with an increased frequency of SGA. Given the impact of advanced maternal age, disease activity, and treatment exposure, close monitoring and individualized management are necessary to achieve the best outcomes for both mother and baby.
