RT Journal Article
SR Electronic
T1 Reasons for the High Cesarean Delivery Rate among Women with Ankylosing Spondylitis: Using the Korean National Health Insurance Database
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 668
OP 673
DO 10.3899/jrheum.190754
VO 47
IS 5
A1 Jung Sun Lee
A1 Ji Seon Oh
A1 Ye-Jee Kim
A1 Seokchan Hong
A1 Chang-Keun Lee
A1 Bin Yoo
A1 Yong-Gil Kim
YR 2020
UL http://www.jrheum.org/content/47/5/668.abstract
AB Objective. Women with ankylosing spondylitis (AS) have reported a higher rate of cesarean births than healthy controls. This study aimed to identify factors associated with cesarean births in women with AS.Methods. Based on the Korean Health Insurance Review and Assessment Service claims database, the subjects comprised female patients aged 20–49 years old with AS. In total, 1293 deliveries after AS diagnosis were included. A logistic regression analysis was performed to identify factors associated with cesarean births.Results. Among the 1293 deliveries in women with AS, 657 were cesarean and 636 were vaginal deliveries. Compared to vaginal delivery, the women who had cesarean deliveries were older, had a longer disease duration, and had a higher portion of primipara and dispensation of drugs. These factors were associated with a higher risk of cesarean delivery: maternal age (OR 1.08, 95% CI 1.04–1.12), disease duration (OR 1.09, 95% CI 1.03–1.14), and preeclampsia (OR 3.94, 95% CI 1.17–13.32). Further, compared to no drug dispensation, these drugs showed higher risks of cesarean delivery: nonsteroidal antiinflammatory drugs (NSAID; OR 1.64, 95% CI 1.31–2.37), tumor necrosis factor inhibitor (TNFi), disease-modifying antirheumatic drugs (DMARD), or corticosteroids (OR 2.01, 95% CI 1.57–2.58). In the subgroup analysis in primiparas, maternal age, or dispensation of NSAID alone, or TNFi, DMARD, or corticosteroids was associated with a higher risk of cesarean delivery.Conclusion. Women with AS showed a higher cesarean delivery rate, influenced by both maternal age and disease-related factors.