Biological therapy and pregnancy outcomes in patients with inflammatory rheumatic diseases Objectives: The aim of this study was to determine the correlation between disease activity and use of bDMARD with pregnancy outcomes in patients with inflammatory rheumatic diseases. Study design: cross-sectional study Participants and Methods: The study included 18 patients with inflammatory rheumatic disease in which pregnancy was recorded while treated at the Institute for Rheumatology, Clinical Immunology and Allergies of CHC Osijek. Data were recorded for a total of 24 pregnancies. 11 patients used biological therapy before/during pregnancy. The control group of 8 patients diagnosed with inflammatory rheumatic disease did not use biological therapy before/during pregnancy. The data was collected from the medical records. Fisher's exact test was used for the statistical data processing. The significance level was set at Alpha = 0.05. Results: The median age of patients in the control group is 31, and the median age of patients on biological therapy is 34. The most common diagnosis is RA in 17/24 pregnancies, PsA in 4/24 pregnancies, and AS in 2/24. There is no significant difference in the distribution of pregnancies with regard to the diagnosis in relation to the groups. Considering the disease activity during pregnancy in patients on biological therapy, 5/9 pregnancies had low activity, 2/9 had medium and 2/9 high disease activity. Of the 4 pregnancies with high and medium disease activity, 2 are in progress and 2 ended in term delivery. There is no significant difference in the presence of complications regarding the control group of pregnancies and pregnancies on biological therapy. There is no significant difference in the distribution of pregnancies with regard to pregnancy outcome and group. Conclusion: Half of the pregnancies with medium or high disease activity are ongoing and without complications, and half ended in term delivery of a healthy child. There is no significant difference in the distribution of pregnancies with regard to pregnancy outcome and group.