{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:24Z","timestamp":1792787304426,"version":"4.5.0"},"reference-count":42,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Association Prix Veronique Roualet"},{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]},{"name":"AFM-Telethon"},{"name":"Cochin Hospital"},{"name":"Association Francophone contre la Polychondrite chronique atrophiante"},{"DOI":"10.13039\/100020799","name":"Association des Scl\u00e9rodermiques de France","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020799","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"}]},{"name":"the French Society of Internal Medicine and Rheumatology"},{"name":"Association Gougerot Sjogren"},{"name":"The French Health Ministry"},{"name":"Lupus France"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,3,31]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This ancillary study from the French multicentre prospective cohort (GR2-\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02450396\">NCT02450396<\/jats:ext-link>\n                      ) 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, &lt;6 months and \u22656 months).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006593","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:25:21Z","timestamp":1777382721000},"page":"e006593","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct02450396","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02450396","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2635-4264","authenticated-orcid":false,"given":"Marie","family":"Hornez","sequence":"first","affiliation":[{"name":"Service de Rhumatologie, Universit\u00e9 de Lille, CHU Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-1986","authenticated-orcid":false,"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Statistics, Universit\u00e9 Paris Cit\u00e9; Universit\u00e9 Sorbonne Paris Nord; INSERM; INRAE, Paris, France"},{"name":"Service de Rhumatologie, H\u00f4pital Bichat, APHP, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Leroy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, CHU Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Banneville","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Universit\u00e9 and Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakiba","family":"Belkhir","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Universit\u00e9 Paris-Saclay, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Le Kremlin-Bicetre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elodie","family":"Chauvet","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, CHU Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2001-1132","authenticated-orcid":false,"given":"Marion","family":"Couderc","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Dernis","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Caen, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Devauchelle-Pensec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, UMR1227, Lymphocytes B et Autoimmunit\u00e9, Universit\u00e9 de Bretagne occidentale, Inserm, CHU Brest, LabEx IGO, Brest, France"},{"name":"Rheumatology Unit, Centre National de R\u00e9f\u00e9rence des Maladies Auto-Immunes Rares (CERAINOM), CHU, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Frazier","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Universit\u00e9 Paris Cit\u00e9, AP-HP, H\u00f4pital Lariboisi\u00e8re, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4528-310X","authenticated-orcid":false,"given":"Laure","family":"Gossec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Universit\u00e9 and Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Gervais","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Poitiers, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1177-9497","authenticated-orcid":false,"given":"Hubert","family":"Marotte","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Universit\u00e9 Jean Monnet Saint-\u00c9tienne, CHU Saint-Etienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Richez","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, National Reference Center for Systemic Autoimmune Rare Diseases, Bordeaux University Hospital, H\u00f4pital Pellegrin, Bordeaux, France"},{"name":"CNRS, Immunoconcept, UMR 5164, Bordeaux University, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie","family":"Sellam","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine; 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The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrositis, and intermittent hydrarthrosis. In: Classic Papers in Rheumatology. CRC Press, 2001."},{"key":"2026042806251264000_12.2.e006593.4","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199906)42:6<1219::AID-ANR19>3.0.CO;2-G"},{"key":"2026042806251264000_12.2.e006593.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.24003"},{"key":"2026042806251264000_12.2.e006593.6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180226"},{"key":"2026042806251264000_12.2.e006593.7","doi-asserted-by":"crossref","first-page":"3465","DOI":"10.1007\/s10067-021-05588-9","article-title":"Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review","volume":"40","author":"Mokbel","year":"2021","journal-title":"Clin Rheumatol"},{"key":"2026042806251264000_12.2.e006593.8","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.016881"},{"key":"2026042806251264000_12.2.e006593.9","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1093\/rheumatology\/key047","article-title":"Disease activity during and after pregnancy in women with axial spondyloarthritis: a prospective multicentre study","volume":"57","author":"Ursin","year":"2018","journal-title":"Rheumatology (Sunnyvale)"},{"key":"2026042806251264000_12.2.e006593.10","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180805"},{"key":"2026042806251264000_12.2.e006593.11","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181067"},{"key":"2026042806251264000_12.2.e006593.12","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780370605"},{"key":"2026042806251264000_12.2.e006593.13","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200005)43:5<1010::AID-ANR8>3.0.CO;2-O"},{"key":"2026042806251264000_12.2.e006593.14","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.084707"},{"key":"2026042806251264000_12.2.e006593.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.20621"},{"key":"2026042806251264000_12.2.e006593.16","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1007\/s10067-018-04415-y","article-title":"Prolactin, autoimmunity, and motherhood: when should women avoid breastfeeding?","volume":"38","author":"Vieira Borba","year":"2019","journal-title":"Clin Rheumatol"},{"key":"2026042806251264000_12.2.e006593.17","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1093\/rheumatology\/kev404","article-title":"BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding\u2014Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids: Table 1","volume":"55","author":"Flint","year":"2016","journal-title":"Rheumatology (Sunnyvale)"},{"key":"2026042806251264000_12.2.e006593.18","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208840"},{"key":"2026042806251264000_12.2.e006593.19","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/art.41191","article-title":"2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases","volume":"72","author":"Sammaritano","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"2026042806251264000_12.2.e006593.20","unstructured":"European Network of Pregnancy Registers in Rheumatology (EuNeP) . An overview of procedures and data collection. Arthritis Research & Therapy. Available: https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/s13075-019-2019-3 [Accessed 03 May 2023]."},{"key":"2026042806251264000_12.2.e006593.21","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-019-2019-3","article-title":"European Network of Pregnancy Registers in Rheumatology (EuNeP)-an overview of procedures and data collection","volume":"21","author":"Meissner","year":"2019","journal-title":"Arthritis Res Ther"},{"key":"2026042806251264000_12.2.e006593.22","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218356"},{"key":"2026042806251264000_12.2.e006593.23","doi-asserted-by":"crossref","first-page":"e330","DOI":"10.1016\/S2665-9913(23)00099-1","article-title":"Pregnancy outcomes in women with primary Sj\u00f6gren\u2019s syndrome: an analysis of data from the multicentre, prospective, GR2 study","volume":"5","author":"de Fr\u00e9mont","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"2026042806251264000_12.2.e006593.24","doi-asserted-by":"crossref","first-page":"e842","DOI":"10.1016\/S2665-9913(22)00308-3","article-title":"Characterisation of a high-risk profile for maternal thrombotic and severe haemorrhagic complications in pregnant women with antiphospholipid syndrome in France (GR2): a multicentre, prospective, observational study","volume":"4","author":"Murarasu","year":"2022","journal-title":"Lancet Rheumatol"},{"key":"2026042806251264000_12.2.e006593.25","first-page":"65","article-title":"The development of the disease activity score (DAS) and the disease activity score using 28 joint counts (DAS28)","volume":"32","author":"van Riel","year":"2014","journal-title":"Clin Exp Rheumatol"},{"key":"2026042806251264000_12.2.e006593.26","doi-asserted-by":"crossref","first-page":"105505","DOI":"10.1016\/j.jbspin.2022.105505","article-title":"Evaluating remission and low disease activity from the perspective of the patient with axial spondyloarthritis: The cross-sectional ConREspAx study","volume":"90","author":"Valero","year":"2023","journal-title":"Joint Bone Spine"},{"key":"2026042806251264000_12.2.e006593.27","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.4103\/ijmr.IJMR_701_15","article-title":"Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation","volume":"146","author":"Kumar","year":"2017","journal-title":"Indian J Med Res"},{"key":"2026042806251264000_12.2.e006593.28","unstructured":"Partial residuals for the proportional hazards regression model. 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