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Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort

rmdopen · 2026-04-28 · canonical JSON source

22 visible annotations · policy: published · automated confidence ≥ 75.00%

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Objective To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity.Method This ancillary study from the French multicentre prospective cohort (GR2- NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months).Results Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.Conclusion RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.