{
  "abstract": "Objective To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity.Method This ancillary study from the French multicentre prospective cohort (GR2- NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months).Results Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.Conclusion RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.",
  "authors": [
    {
      "affiliations": [
        "Service de Rhumatologie, Université de Lille, CHU Lille, Lille, France"
      ],
      "name": "Marie Hornez"
    },
    {
      "affiliations": [
        "Centre for Research in Epidemiology and Statistics, Université Paris Cité",
        "Université Sorbonne Paris Nord",
        "INSERM",
        "INRAE, Paris, France",
        "Service de Rhumatologie, Hôpital Bichat, APHP, Paris, France"
      ],
      "name": "Anna Molto"
    },
    {
      "affiliations": [
        "Department of Biostatistics, CHU Lille, Lille, France"
      ],
      "name": "Maxime Leroy"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"
      ],
      "name": "Béatrice Banneville"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"
      ],
      "name": "Rakiba Belkhir"
    },
    {
      "affiliations": [
        "Service de Médecine Interne, CHU Montpellier, Montpellier, France"
      ],
      "name": "Elodie Chauvet"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France"
      ],
      "name": "Marion Couderc"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, CHU Caen, Caen, France"
      ],
      "name": "Emmanuelle Dernis"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne occidentale, Inserm, CHU Brest, LabEx IGO, Brest, France",
        "Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU, Brest, France"
      ],
      "name": "Valérie Devauchelle-Pensec"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Université Paris Cité, AP-HP, Hôpital Lariboisière, Paris, France"
      ],
      "name": "Aline Frazier"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"
      ],
      "name": "Laure Gossec"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, CHU Poitiers, Poitiers, France"
      ],
      "name": "Elisabeth Gervais"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Université Jean Monnet Saint-Étienne, CHU Saint-Etienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, Saint-Étienne, France"
      ],
      "name": "Hubert Marotte"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, National Reference Center for Systemic Autoimmune Rare Diseases, Bordeaux University Hospital, Hôpital Pellegrin, Bordeaux, France",
        "CNRS, Immunoconcept, UMR 5164, Bordeaux University, Bordeaux, France"
      ],
      "name": "Christophe Richez"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Hôpital Saint-Antoine",
        "Assistance Publique–Hôpitaux de Paris (AP-HP)",
        "Sorbonne Université, Paris, France"
      ],
      "name": "Jérémie Sellam"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"
      ],
      "name": "Raphaele Seror"
    },
    {
      "affiliations": [
        "Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"
      ],
      "name": "Véronique Le Guern"
    },
    {
      "affiliations": [
        "Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"
      ],
      "name": "Gaëlle Guettrot-Imbert"
    },
    {
      "affiliations": [
        "Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"
      ],
      "name": "Nathalie Costedoat-Chalumeau"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Université de Lille, CHU Lille, FHU PRECISE, Lille, France"
      ],
      "name": "René-Marc Flipo"
    },
    {
      "affiliations": [
        "Service de Rhumatologie, Université de Lille, CHU Lille, FHU PRECISE, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France"
      ],
      "name": "Jean-Guillaume Letarouilly"
    }
  ],
  "title": "Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort",
  "uid": "154a739b-3a1c-50ff-819b-ccc027338c3a"
}