Pregnancy Outcomes in Rheumatoid Arthritis Patients: A Retrospective Population-based Cohort Study

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Pregnancy Outcomes in Rheumatoid Arthritis Patients: A Retrospective Population-based Cohort Study
Key Take-Away: 

Pregnancy modifies the immune state, most likely causing a change in the course of rheumatoid arthritis (RA). Hissay Aljary et al. evaluated in their cohort study that pregnant women are at a greater plausibility of adverse maternal and neonatal outcomes and they should also be made well-informed of these risks.
 

Introduction:

To investigate whether pregnancies in women with rheumatoid arthritis (RA) are at a higher risk of adverse maternal and neonatal outcomes.

 

Methods:

A retrospective cohort study was conducted via the Healthcare Cost and Utilization Project – National Inpatient Sample (HCUP-NIS) from the USA. All births that took place between 2004-2013 were recognised. The women were classified as having RA or not based on ICD-9 coding. Unconditional logistic regression helped to evaluate the adjusted effect of RA on maternal and neonatal outcomes.

 

Results:

Of the total 8,417,607 births, 6068 were among women suffering from RA for an overall incidence of 72 per 100,000 births. There was a stable increase in reported RA in pregnancy from 47 to 100 per 100,000 over the 10-year study duration. Women with RA were more likely to initiate pre-eclampsia/eclampsia, gestational diabetes, to present with preterm premature rupture of membranes (PPROM), to experience placental abruption and placenta previa, and to deliver by caesarean section. Wound difficulties and thromboembolisms were associated with postpartum, RA-complicated pregnancies. Congenital anomalies, small for gestational age and preterm birth were more frequent in neonates of women with RA.

Conclusion:

RA in pregnancy is connected with a higher likelihood of adverse maternal and neonatal results. Women with RA should be informed of these risks and be followed as a high-risk pregnancy.

Source

The Journal of Maternal-Fetal & Neonatal Medicine

Link:

https://www.tandfonline.com/doi/abs/10.1080/14767058.2018.1498835?journalCode=ijmf20

Original title of the article:

Pregnancy outcomes in women with rheumatoid arthritis: a retrospective population-based cohort study

Authors:

Hissay Aljary et al.

Exploratory, Rheumatoid arthritis, Retrospective population-based cohort study, Wound complications, Thromboembolisms
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