RT Journal Article
SR Electronic
T1 A Population Level Analysis of the Differing Impacts of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.181320
DO 10.3899/jrheum.181320
A1 Stephanie Keeling
A1 Samantha Bowker
A1 Anamaria Savu
A1 Padma Kaul
YR 2019
UL http://www.jrheum.org/content/early/2019/04/24/jrheum.181320.abstract
AB Objective The impact of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level has not previously been well compared. Methods A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of one live birth event per woman. We identified three groups: (1) no inflammatory arthritis (no IA, N=308,989), (2) RA (N=631), and (3) SpA (N=2,461). We compared maternal and neonatal outcomes, co-morbid conditions and medication use between the three groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy. Results Pregnant women with RA were significantly more likely to have pre-term deliveries (13.5%), caesarean sections (33.9%), hypertensive disorders in pregnancy (10.5%) and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Non-steroidal anti-inflammatories (NSAIDs) and corticosteroid use was significantly higher in pregnant RA women compared to the other groups. RA women were significantly more likely to have an SGA baby (OR 1.51; 95% CI 1.21-1.88, p <0.01), and hypertensive disorder in pregnancy (OR 1.51; 95% CI 1.16-1.97, p<0.01), compared to no IA women while no difference was found between women with SpA and those with no IA. Conclusion Women with RA have a higher risk of worse maternal and neonatal outcomes whereas the risk of these events is similar between women with and without SpA.