Reference: October 2025 | Issue 10 | Vol 11 | Page 4
Highlights from EULAR 2025
To address the lack of prospective large cohort data on pregnancy outcomes in women with autoinflammatory disease, a French multi-centre prospective pregnancy observational cohort was set up to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health.
The work, presented at EULAR 2025, reported findings from 97 women with an autoinflammatory disease, which highlighted the need for close monitoring of these patients and collaboration between clinicians.
Familial Mediterranean fever (FMF) was the most common diagnosis (81 per cent), followed by undifferentiated systemic autoinflammatory diseases (USAID), tumour necrosis factor receptor-associated periodic syndrome, cryopyrin-associated periodic syndromes (CAPS), Still’s disease, recurrent pericarditis, mevalonate kinase deficiency, A20 haploinsufficiency, and other rare diseases.
During the period 2016 to 2024, the 97 women studied carried 115 pregnancies, including five sets of
twins. Sixteen pregnancies were terminated before the 37th week of gestation, including two foetal deaths in utero, two therapeutic abortions due to chromosomal abnormalities, and one spontaneous abortion. In the year prior to pregnancy, 57.7 per cent of women had signs of disease activity, and 59.1 per cent experienced flares during their pregnancy.
In women with FMF, the median age at onset was six years, and they were 31 when they got pregnant, with 15 per cent needing assisted reproduction. They reported a mean of four disease flares per year in the year prior to pregnancy. Inflammatory symptoms during pregnancy were reported in 65.7 per cent of cases, including three prolonged febrile myalgia syndromes.
Pregnancy complications included one risk of preterm delivery in a twin pregnancy. One patient experienced one anamnios and one oligohydramnios during both of her pregnancies.
Overall, 17 per cent of women delivered their baby before 37 weeks – higher than the 7 per cent expected in the general population for France – and 22.4 per cent of singleton babies had a birth weight below the 10th percentile, compared to only 7.1 per cent in the general population.
In women with USAID, the median age at disease onset was 14, and they were 30 when they got pregnant. Half were receiving colchicine. Biologic therapy was discontinued in two women upon discovery of pregnancy. Only one had a birth weight less than the 10th percentile.
When looking at markers of inflammation, the group found that women with USAID had mean C-reactive protein at enrolment of 8.9mg/dL, compared to 22.5mg/dL for women with FMF.
