Biologic Exposure Not Linked to Increased Adverse Pregnancy Outcomes in PsO: Study

Biologic therapy was not associated with increased adverse pregnancy outcomes among patients with psoriasis in a large real-world cohort study published in the Journal of the American Academy of Dermatology. 

Investigators compared 1,226 biologic-exposed pregnancies with 1,238 pregnancies in patients with psoriasis who had no history of biologic treatment. The retrospective study included patients aged 15 to 49 years treated at Sheba Medical Center in Israel from 2010 through 2024. Biologics included TNF-α, IL-17, IL-23, and IL-12/23 inhibitors.

Biologic Safety During Pregnancy in Patients With Psoriasis

Any adverse pregnancy outcome occurred in 24.1% of biologic-exposed patients compared with 30.0% of unexposed controls (OR, 0.76; 95% CI, 0.64 to 0.89; P = 0.0013). Spontaneous abortion occurred in 8.4% versus 10.9%, respectively (OR, 0.75; 95% CI, 0.57 to 0.98; P = 0.0406), while gestational diabetes occurred in 4.2% versus 7.4% (OR, 0.54; 95% CI, 0.38 to 0.77; P < 0.001).

Rates of stillbirth, preterm birth, low birth weight, preeclampsia, gestational hypertension, placental complications, postpartum hemorrhage, fetal growth restriction, and cesarean delivery did not differ significantly between groups. Neonatal outcomes were also broadly comparable. The authors reported that TNF-α inhibitors accounted for approximately 85% of biologic exposures. Adverse pregnancy outcomes did not differ across biologic classes.

“Biologic-exposed psoriasis patients did not exhibit increased risk of any adverse pregnancy outcome compared with unexposed controls,” the authors concluded.

Source

Bar D, et al. JAAD. 2026. Doi:10.1016/j.jaad.2026.06.006