Biologic Exposure and Pregnancy Outcomes in Psoriasis

Key Takeaways

• Among pregnancies in patients with psoriasis, any adverse pregnancy outcome occurred in 24.1% with biologic exposure during pregnancy versus 30% in unexposed psoriasis controls.
• Spontaneous abortion was less frequent with biologic exposure than without it.
• Gestational diabetes mellitus was also less frequent with biologic exposure than without it.

Investigators assembled a retrospective observational cohort for a comparison of pregnancy outcomes in biologic-exposed patients with psoriasis. Participants were females aged 15 to 49 years with psoriasis, including 1,226 exposed to biologic agents during pregnancy and 1,238 unexposed psoriasis controls. Investigators compared the occurrence of any adverse pregnancy outcome and examined individual outcomes, including spontaneous abortion and gestational diabetes mellitus.

Any adverse pregnancy outcome was less frequent among biologic-exposed patients than among unexposed psoriasis controls. The reported odds ratio (OR) was 0.76.

Spontaneous abortion was less frequent among biologic-exposed patients than among unexposed psoriasis controls, with a reported OR of 0.75. Gestational diabetes mellitus was also less frequent among biologic-exposed patients, with a reported OR of 0.54.

The authors noted the retrospective design, limited power to assess biologic subclasses other than tumor necrosis factor alpha (TNF-alpha) agents, and incomplete characterization of exposure duration by trimester. Lower observed odds do not demonstrate that biologics prevent pregnancy complications, nor do these findings establish outcomes for every biologic subclass or exposure period.

The authors concluded that biologic-exposed patients with psoriasis did not show higher overall observed adverse pregnancy outcomes than unexposed psoriasis controls.