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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 4

(1196) No association between biological therapeutics and infections in pregnant patients with autoimmune disease

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: The incidence of autoimmune disease (AID) peaks during reproductive years. Active AID increases pregnancy risks, making disease control during pregnancy crucial for improving maternal and fetal outcomes. Biologic therapeutics (biologics) targeting the immune system have significantly improved AID management. Current clinical guidelines generally recommend continuation of biologics during pregnancy to maintain clinical remission, however, there is conflicting evidence regarding risk of infections. This study evaluates the association between the use of biologics during pregnancy and peripartum infections.

Study Design: We performed a retrospective cohort study including pregnant patients with autoimmune disease from a single institution during 2013-2023. Data on demographics, medical conditions, pregnancy, and therapeutics was abstracted from the medical record. The primary outcomes were rates of antepartum and postpartum infections between patients exposed to biologics during pregnancy versus unexposed. We hypothesized that the rate of antepartum and postpartum infections is higher in patients exposed to biologics during pregnancy compared to unexposed.

Results: We identified a total of 202 pregnancies in 131 individuals. 94 pregnancies (46.5%) were exposed to biologics, while 108 (53.5%) pregnancies were unexposed.  Logistic regression adjusted for non-independent data was used to assess the association between biologic exposure and antepartum and postpartum infections. There was no significant difference in the rates of overall antepartum (p = 0.66) or postpartum (p = 0.39) infections between the biologics exposed and unexposed pregnancies as well as no difference in the rates of individual infections. 

Conclusion: There was no significant association between the use of biologics during pregnancy and the incidence of peripartum infections. Studies in larger populations are needed to confirm safety of biologics during pregnancy as they may be useful for treatment of pregnancy complications related to inflammation.