Summary of disease activity scoring systems used in the 10 papers evaluated for final analysis, and an indication of the different objective disease activity scoring systems and criteria for disease activity alterations used during pregnancy and postpartum.
| First Author, Year | Disease Scoring Systems Used | Criteria for Improvement of Disease Activity during Pregnancy | Criteria for Postpartum Relapse |
|---|---|---|---|
| Ostensen, 19834 (A&R) | Score derived from duration of morning stiffness, Ritchie articular index, swollen joint count, grip strength, functional class, performance of activities of daily living | Not specified | |
| Ostensen, 198312 (SJR) | Score derived from duration of morning stiffness, Ritchie articular index, swollen joint count, grip | Not specified | |
| Unger, 19835 | Camp index | If the clinician defined the patient as having low disease activity prepregnancy (1–3 active joints), remission defined as mean Camp index < 6 in third trimester (T3); if moderate disease activity prepregnancy (≥ 4 active joints), remission defined as mean Camp index < 16 in T3 | |
| Ostensen, 20046 | RADAI, 44 joint count, HAQ | Remission defined as morning stiffness duration < 15 min, no soft tissue swelling, no joint tenderness/pain on movement, no drug treatment required | Not specified; 6 and 12 weeks postpartum |
| Forger, 20059 | RADAI, SF-36 | Not specified | Not specified; 6, 12, and 24 weeks postpartum |
| Ostensen, 200511 | RADAI, tender joint count, swollen joint count, physician’s global assessment | Not specified | |
| De Man, 20083 | DAS28-CRP3 | EULAR response criteria; patients all had DAS28-CRP3 ≥ 3.2 in T1; moderate/good response during pregnancy defined as reduction of DAS28-CRP3 > 0.6 in T3, compared to T1 | Reversed EULAR response criteria. Moderate/severe flare defined as > 0.6 increase in DAS28-CRP3 at 12 or 26 weeks postpartum, compared to 6 weeks postpartum |
| Forger, 20127 | DAS28-CRP | DAS28-CRP < 3.2 in T3: either low disease activity throughout or decreasing disease activity during pregnancy | DAS28-CRP > 3.2 at 6 weeks postpartum |
| Weix, 201310 | DAS28-CRP | DAS28 < 2.6 in T2/T3 | DAS28-CRP > 3.2 at 6 weeks postpartum |
| Atta, 20168 | DAS28-CRP3 | Not specified |
RADAI: Rheumatoid Arthritis Disease Activity Index; SF-36: Medical Outcomes Study Short Form-36; HAQ: Health Assessment Questionnaire;Arthritis and DAS28-CRP3: 28-joint count Disease Activity Score using C-reactive protein 3; EULAR: European League Against Rheumatism; A&R: Arthritis and Rheumatology; SJR: Scandinavian Journal of Rheumatology.