title: Psoriatic arthritis disease activity during pregnancy and the first-year postpartum.
abstract: To evaluate disease activity in the joints and skin during pregnancy and the first-year postpartum in patients with psoriatic arthritis (PsA).
  
  
  
  Women with PsA who were pregnant between 1990 and 2015 with at least 1 clinic visit during pregnancy were identified from the Toronto PsA database. The course of joint and skin disease activity was defined by the following 5 states: improvement, worsening, stable low, stable high, or a mixed. As controls, 67 nonpregnant PsA women were identified and evaluated over a similar timeframe.
  
  
  
  Altogether, 29 PsA women with 42 pregnancies were identified. Of the 42 pregnancies, 40 (95%) resulted in normal live birth. Arthritis improved or was stable low activity in 24 (58.5%) of pregnancies. During the postpartum period, 21 (52.5%) had either improvement or stable low PsA activity, whereas 16 (40%) had either worsening or stable high disease activity. The skin activity during pregnancy either improved or stayed in a stable low state in 30 (88.2%), and in the postpartum period there was worsening in 15 (42.9%). A logistic regression analysis revealed a favourable skin disease course during the pregnancy period in the pregnant group compared to the control group (OR = 6.8, p = 0.004), but not in joint disease.
  
  
  
  The outcome of pregnancy among patients with PsA is excellent. Arthritis activity trends toward a favourable course while the skin disease shows a favorable course during pregnancy. When compared to controls, pregnancy period has significant beneficial influence only on the skin but not on the joints in PsA.
authors.affiliation: Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ari
authors.initials: A
authors.lastname: Polachek
authors.affiliation: Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Li
authors.affiliation: Reproductive Life Stages Program, Women׳s College Hospital, Toronto, Ontario, Canada.
authors.forename: Inbal Shlomi
authors.initials: IS
authors.lastname: Polachek
authors.affiliation: Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Vinod
authors.initials: V
authors.lastname: Chandran
authors.affiliation: Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Psoriatic Arthritis Program, Center for Prognostic Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: dafna.gladman@utoronto.ca.
authors.forename: Dafna
authors.initials: D
authors.lastname: Gladman
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000175:diagnosis*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012720:Severity of Illness Index
keywords: Birth; Gestation; Joints; Psoriatic arthritis; Skin; Treatment