Pregnancy, Immunosuppressive Therapy, and Risk for Serious Infections

Effective management of autoimmune inflammatory diseases relies on chronic immunosuppression. To quantify risk for serious infection in pregnant women receiving immunosuppressive agents, investigators analyzed prospectively collected data on 4961 pregnant U.S. women with diagnoses of rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, psoriatic arthritis, or inflammatory bowel disease who filled prescriptions for oral steroids, nonbiologic agents (e.g., methotrexate), or tumor necrosis factor α (TNF) inhibitors. Serious infections were defined as a composite outcome of community acquired (e.g., pneumonia, pyelonephritis) or opportunistic (e.g., cryptococcosis) infections.

Incidence of serious infection was 3.4 per 100…