{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:11:15Z","timestamp":1767791475869,"version":"3.49.0"},"reference-count":39,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:00:00Z","timestamp":1759622400000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","award":["R-968633"],"award-info":[{"award-number":["R-968633"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004785","name":"NordForsk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008368","name":"Gigtforeningen","doi-asserted-by":"publisher","award":["R151-A4623"],"award-info":[{"award-number":["R151-A4623"]}],"id":[{"id":"10.13039\/100008368","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008368","name":"Gigtforeningen","doi-asserted-by":"publisher","award":["R161-A5262"],"award-info":[{"award-number":["R161-A5262"]}],"id":[{"id":"10.13039\/100008368","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014034","name":"Foundation for Research in Rheumatology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014034","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,7,3]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate risk and to identify risk factors for preterm birth in pregnant women with psoriatic arthritis (PsA) in relation to maternal characteristics, treatment and disease activity, both before and during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We linked clinical rheumatology registers to medical birth registers in Sweden, Denmark and Norway and identified PsA pregnancies and control pregnancies 2006\u20132021, matched 1:10 on age, parity, country and birth year. Adjusted ORs (aORs) for preterm birth in PsA pregnancies vs control pregnancies were calculated overall and stratified by maternal characteristics, antirheumatic treatment and disease load (9\u2009months before and during pregnancy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed 54 preterm births among 688 PsA pregnancies (7.8%) versus 312 among 6880 control pregnancies (4.5%); aOR, 95% CI: 1.80, 1.29 to 2.51. The risk estimate was largely unaffected by parity, smoking and body mass index. PsA pregnancies exposed to a combination of biologic and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and\/or glucocorticoids during pregnancy had a markedly increased risk of preterm birth compared with control pregnancies (4.44, 2.07 to 9.50), whereas exposure to biological DMARD (bDMARD) monotherapy (primarily tumour necrosis factor inhibitors) had not (0.73, 0.22 to 2.42). High disease load before pregnancy was associated with increased risk. The proportion of preterm birth was higher in those stopping bDMARD during the first trimester (21%) opposed to those continuing past the first trimester (10%) based on few events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified an 80% increased risk of preterm birth in PsA pregnancies compared with control pregnancies. Antirheumatic combination therapy during and high disease load before pregnancy constituted risk factors. Discontinuing bDMARD treatment in early pregnancy further increased the risk. Our findings support that a subgroup of PsA pregnancies should be considered high-risk pregnancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005614","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:35:21Z","timestamp":1759732521000},"page":"e005614","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Preterm birth in women with psoriatic arthritis: what are the risks and risk factors? A collaborative cohort study from Sweden, Denmark and Norway"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0541-0733","authenticated-orcid":false,"given":"Anne Emilie Pape","family":"Secher","sequence":"first","affiliation":[{"name":"COPECARE (Copenhagen Center for Arthritis Research, Centre for Rheumatology and Spine Diseases), HovedOrtoCentret, Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrik","family":"Granath","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0971-132X","authenticated-orcid":false,"given":"Katarina","family":"Remaeus","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bente","family":"Glintborg","sequence":"additional","affiliation":[{"name":"COPECARE (Copenhagen Center for Arthritis Research, Centre for Rheumatology and Spine Diseases), HovedOrtoCentret, Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"},{"name":"DANBIO, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2474-2677","authenticated-orcid":false,"given":"Ane Lille\u00f8re","family":"Rom","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fertility and Obstetrics, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark"},{"name":"Research Unit of Gynaecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Michelsen","sequence":"additional","affiliation":[{"name":"Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"},{"name":"Research Unit, S\u00f8rlandet Sykehus HF, Kristiansand, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4229-6818","authenticated-orcid":false,"given":"Merete Lund","family":"Hetland","sequence":"additional","affiliation":[{"name":"COPECARE (Copenhagen Center for Arthritis Research, Centre for Rheumatology and Spine Diseases), HovedOrtoCentret, Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7149-0973","authenticated-orcid":false,"given":"Karin","family":"Hellgren","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden"},{"name":"Centre for Rheumatology, Academic Specialist Center, Karolinska Institute, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,5]]},"reference":[{"key":"2026010700550709000_11.4.e005614.1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210963"},{"key":"2026010700550709000_11.4.e005614.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2021.101692"},{"key":"2026010700550709000_11.4.e005614.3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab894"},{"key":"2026010700550709000_11.4.e005614.4","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2022-002445","article-title":"Risk of pre-eclampsia and impact of disease activity and antirheumatic treatment in women with rheumatoid arthritis, axial spondylarthritis and psoriatic arthritis: a collaborative matched cohort study from Sweden and Denmark","volume":"8","author":"Secher","year":"2022","journal-title":"RMD Open"},{"key":"2026010700550709000_11.4.e005614.5","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1002\/acr.23730","article-title":"Factors Associated With Preterm Delivery Among Women With Rheumatoid Arthritis and Women With Juvenile Idiopathic Arthritis","volume":"71","author":"Smith","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026010700550709000_11.4.e005614.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.24914"},{"key":"2026010700550709000_11.4.e005614.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/rmdopen-2023-003762","article-title":"Pregnancy outcomes in women with rheumatoid arthritis: an 11-year French nationwide study","volume":"10","author":"Pina Vegas","year":"2024","journal-title":"RMD Open"},{"key":"2026010700550709000_11.4.e005614.8","doi-asserted-by":"crossref","first-page":"3265","DOI":"10.1002\/art.38874","article-title":"Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis: a nationwide cohort study","volume":"66","author":"Rom","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2026010700550709000_11.4.e005614.9","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1002\/acr.23924","article-title":"Birth Outcomes and Disease Activity During Pregnancy in a Prospective Cohort of Women With Psoriatic Arthritis and Ankylosing Spondylitis","volume":"72","author":"Smith","year":"2020","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026010700550709000_11.4.e005614.10","doi-asserted-by":"crossref","first-page":"728","DOI":"10.2340\/00015555-2923","article-title":"Effect of Maternal Psoriasis on Pregnancy and Birth Outcomes: A Population-based Cohort Study from Denmark and Sweden","volume":"98","author":"Br\u00f6ms","year":"2018","journal-title":"Acta Derm Venereol"},{"key":"2026010700550709000_11.4.e005614.11","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1111\/1471-0528.15836","article-title":"Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study","volume":"126","author":"Remaeus","year":"2019","journal-title":"BJOG"},{"key":"2026010700550709000_11.4.e005614.12","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/art.41985","article-title":"Pregnancy Outcomes in Women With Psoriatic Arthritis in Relation to Presence and Timing of Antirheumatic Treatment","volume":"74","author":"Remaeus","year":"2022","journal-title":"Arthritis Rheumatol"},{"key":"2026010700550709000_11.4.e005614.13","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.semarthrit.2021.04.003","article-title":"Pregnancy in women with psoriatic arthritis: A systematic literature review of disease activity and adverse pregnancy outcomes","volume":"51","author":"Meissner","year":"2021","journal-title":"Semin Arthritis Rheum"},{"key":"2026010700550709000_11.4.e005614.14","unstructured":"Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes . Mortality and acute complications in preterm infants. In: Behrman RE , Butler AS , eds. Preterm birth: causes, consequences & prevention. National Academies Press (US), 2006: 263."},{"key":"2026010700550709000_11.4.e005614.15","unstructured":"Institute of medicine (us) commitstee on understanding premature birth and assuring healthy outcome . Neurodevelopmental, health, and family outcomes for infants born preterm. In: Behrman RE , Butler AS , eds. Preterm birth: causes, consequences, and prevention. National Academies Press(US), 2006: 397."},{"key":"2026010700550709000_11.4.e005614.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60136-1"},{"key":"2026010700550709000_11.4.e005614.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706475"},{"key":"2026010700550709000_11.4.e005614.18","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2018-000878","article-title":"Impact of autoimmune rheumatic diseases on birth outcomes: a population-based study","volume":"5","author":"Strouse","year":"2019","journal-title":"RMD Open"},{"key":"2026010700550709000_11.4.e005614.19","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1002\/acr.24111","article-title":"Spondyloarthritis and Outcomes in Pregnancy and Labor: A Nationwide Register-Based Cohort Study","volume":"73","author":"M\u00f8rk","year":"2021","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026010700550709000_11.4.e005614.20","doi-asserted-by":"crossref","first-page":"4018","DOI":"10.1093\/rheumatology\/keab357","article-title":"Maternal and neonatal outcomes in pregnant women with psoriasis and psoriatic arthritis: a systematic review and meta-analysis","volume":"60","author":"Xie","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"2026010700550709000_11.4.e005614.21","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2014.927918"},{"key":"2026010700550709000_11.4.e005614.22","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2018-000655","article-title":"Opportunities and challenges for real-world studies on chronic inflammatory joint diseases through data enrichment and collaboration between national registers: the Nordic example","volume":"4","author":"Chatzidionysiou","year":"2018","journal-title":"RMD Open"},{"key":"2026010700550709000_11.4.e005614.23","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S99490"},{"key":"2026010700550709000_11.4.e005614.24","first-page":"S188","article-title":"A Norwegian DMARD register: prescriptions of DMARDs and biological agents to patients with inflammatory rheumatic diseases","volume":"23","author":"Kvien","year":"2005","journal-title":"Clin Exp Rheumatol"},{"key":"2026010700550709000_11.4.e005614.25","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s10654-022-00947-5","article-title":"The Swedish medical birth register during five decades: documentation of the content and quality of the register","volume":"38","author":"Cnattingius","year":"2023","journal-title":"Eur J Epidemiol"},{"key":"2026010700550709000_11.4.e005614.26","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-018-0356-1"},{"key":"2026010700550709000_11.4.e005614.27","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2000.079006435.x"},{"key":"2026010700550709000_11.4.e005614.28","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register","volume":"11","author":"Ludvigsson","year":"2011","journal-title":"BMC Public Health"},{"key":"2026010700550709000_11.4.e005614.29","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"2026010700550709000_11.4.e005614.30","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1294"},{"key":"2026010700550709000_11.4.e005614.31","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw213"},{"key":"2026010700550709000_11.4.e005614.32","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-016-0117-y"},{"key":"2026010700550709000_11.4.e005614.33","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"2026010700550709000_11.4.e005614.34","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208840"},{"key":"2026010700550709000_11.4.e005614.35","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.ard.2025.02.023","article-title":"EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update","volume":"84","author":"R\u00fcegg","year":"2025","journal-title":"Ann Rheum Dis"},{"key":"2026010700550709000_11.4.e005614.36","doi-asserted-by":"publisher","DOI":"10.1002\/art.22773"},{"key":"2026010700550709000_11.4.e005614.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32549-6"},{"key":"2026010700550709000_11.4.e005614.38","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1002\/acr.23621","article-title":"Patient-Reported Disease Activity and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus and Rheumatoid Arthritis","volume":"71","author":"Harris","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026010700550709000_11.4.e005614.39","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60074-4"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2025-005614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:55:18Z","timestamp":1767776118000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2025-005614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,10,5]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/rmdopen-2025-005614"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2025-005614","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}