1/15/2026
According to a recent study published in Annals of the Rheumatic Diseases, people living with spondyloarthritis (SpA) were found to have a higher risk of delivering babies who are small for gestational age. The study did not find an increased risk for other adverse pregnancy outcomes.
Researchers in France followed a group of pregnant women with SpA (both axial and peripheral forms) who were enrolled by their rheumatologists between 2015 and 2021. They collected detailed information throughout pregnancy, including the women’s age, disease activity, medications, and pregnancy outcomes. To compare these pregnancies to the general population, each pregnancy was matched with four pregnancies from large national French birth surveys, selected to be similar in age, location, and whether it was a first pregnancy. The researchers then used statistical analyses to explore factors that might explain any differences between the SpA group and the non-SpA group.
The study examined 135 pregnancies among 124 women with (SpA). Most women were in their early 30s, had lived with SpA for an average of six years, and more than half were experiencing their first pregnancy. Exposure to biologic therapies was common, with nearly 60% using a biologic during pregnancy and more than 70% having used a TNF inhibitor prior to conception.
Overall, the pregnancy outcomes were largely reassuring. More than 92% of pregnancies resulted in live births, and nearly 90% reached full term. In women with SpA, rates of preterm birth, congenital malformations, gestational diabetes, hypertensive disorders, neonatal intensive care transfers, and caesarean delivery were similar to those seen in the general population.
The main difference identified was an increased risk of babies being born small for gestational age (SGA). Infants born to mothers with SpA were nearly twice as likely to be SGA compared with matched controls, including a higher rate of more severe SGA (below the 3rd percentile). Importantly, no maternal or disease-related factors—including disease activity, smoking, body mass index, or use of TNF inhibitors, NSAIDs, or corticosteroids during pregnancy—were found to predict which pregnancies would result in SGA.
The researchers say that these findings offer reassurance for people with spondyloarthritis who are pregnant or considering pregnancy. Despite earlier research suggesting a broad range of increased pregnancy risks, this contemporary, well-controlled study found that most pregnancy and birth outcomes in women with SpA closely resemble those of the general population.
While the increased risk of small-for-gestational-age births highlights the need for careful fetal growth monitoring, the absence of elevated risks for other serious complications supports current approaches to pregnancy management in SpA. Significantly, the use of TNF inhibitors did not appear to worsen pregnancy outcomes, reinforcing growing evidence that modern treatment strategies can help maintain maternal health without compromising pregnancy safety.
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