Cohort study comparing adverse pregnancy outcomes (APOs) in reproductive-age women (15–49 years) with psoriasis who were exposed to biologic agents during pregnancy (n=1,226) versus unexposed psoriasis controls (n=1,238).
Biologic-exposed patients had lower odds of any APO than unexposed controls (24.1% vs 30.0%; OR 0.76; 95% CI 0.64–0.89). Specific reductions were seen in spontaneous abortion (8.40% vs 10.90%; OR 0.75) and gestational diabetes mellitus (4.16% vs 7.43%; OR 0.54).
Retrospective design limits causal inference; limited statistical power for non-TNF-α biologic subclasses; trimester-specific exposure duration was incompletely characterized.
Biologic therapy during pregnancy in psoriasis patients does not appear to raise the risk of adverse pregnancy outcomes — it may even lower it compared with no biologic use. Clinicians can use this data to reassure patients and inform shared decision-making around continuing biologics during pregnancy.
