- Design
- Retrospective cohort
- Population
- 2,464 pregnant women with psoriasis (1,226 biologic-exposed, 1,238 unexposed)
- Primary outcome
- Any adverse pregnancy outcome
- Effect
- 24.1% vs 30.0%; OR 0.76 (0.64–0.89)
This retrospective cohort compared 1,226 pregnant women with psoriasis exposed to a biologic with 1,238 unexposed women with psoriasis.
Any adverse pregnancy outcome occurred in 24.1% of exposed and 30.0% of unexposed women (OR 0.76, 95% CI 0.64–0.89). Biologic exposure was also associated with lower odds of miscarriage (8.4% vs 10.9%) and gestational diabetes (4.2% vs 7.4%).
The lower rates should not be read as biologics protecting pregnancy: women whose disease is well controlled, and who have access to biologics, may differ in many ways from those who do not. Power was limited for non-TNF biologics and exposure timing was incompletely recorded. The useful message is reassurance — the data do not show harm — which supports keeping well-controlled disease controlled rather than stopping treatment by reflex.
- Biologic exposure in pregnancy was not associated with more adverse outcomes in this cohort.
- Most data concern TNF-α inhibitors; evidence for IL-17 and IL-23 agents remains thin.
- Plan treatment around pregnancy jointly with the obstetrician, rather than stopping biologics by reflex.
- Lower event rates in exposed women likely reflect differences between groups, not protection.
Why it matters
Stopping a biologic at conception often triggers flares, and fear of harm is a common reason it happens.
Don't overread it
Observational; the lower rates in exposed women do not mean biologics improve pregnancy outcomes.
The statistics, in plain English
An odds ratio of 0.76 means lower odds of an adverse outcome in exposed women. In an observational study that difference may come from who gets prescribed a biologic, so the safe reading is 'no sign of harm', not 'benefit'.
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