Risk for adverse pregnancy outcome in axial spondyloarthritis and rheumatoid arthritis: disease activity matters.

Zbinden, Astrid; van den Brandt, Stephanie; Østensen, Monika; Villiger, Peter; Förger, Frauke (2018). Risk for adverse pregnancy outcome in axial spondyloarthritis and rheumatoid arthritis: disease activity matters. Rheumatology, 57(7), pp. 1235-1242. Oxford University Press 10.1093/rheumatology/key053

[img] Text
key053.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (198kB)

Objective

To analyse pregnancy outcome and delivery mode in patients with RA and axial spondyloarthritis (axSpA) in relation to disease activity and anti-rheumatic drugs.

Methods

Patients with RA and axSpA were compared with age-matched healthy controls (HCs) with respect to pregnancy outcome and delivery mode. Disease activity (DAS28, ASDAS, CRP) and medication use of patients was assessed once at each trimester. ORs with 95% CI were calculated with univariate and multivariate regression models.

Results

We analysed 244 pregnancies, of which 96 occurred in patients with RA, 78 in patients with axSpA and 70 in HCs. The adjusted analysis showed that pregnant women with RA and axSpA had a higher risk of pregnancy complications (gestational diabetes, preeclampsia, infection, preterm premature rupture of membranes), small for gestational age infants and preterm deliveries (all P < 0.05). Active disease was a predictor for preterm delivery in both RA [odds ratio (OR) = 3.9, 95% CI: 1.25, 12.15] and axSpA (OR = 13.8, 95% CI: 1.33, 143.94). Regarding delivery mode, most patients had vaginal deliveries. However, women with RA revealed an increased risk of caesarean section compared with HC (P < 0.05), which was not seen in patients with axSpA.

Conclusion

Our findings show that disease activity of RA and axSpA during pregnancy influences pregnancy outcome. To allow for successful pregnancy a treatment strategy that targets inactive disease beyond conception should be followed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology

UniBE Contributor:

Villiger, Peter Matthias, Förger, Frauke

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1462-0324

Publisher:

Oxford University Press

Language:

English

Submitter:

Burkhard Möller

Date Deposited:

26 Jul 2019 08:23

Last Modified:

05 Dec 2022 15:25

Publisher DOI:

10.1093/rheumatology/key053

PubMed ID:

29617883

BORIS DOI:

10.7892/boris.125128

URI:

https://boris.unibe.ch/id/eprint/125128

Actions (login required)

Edit item Edit item
Provide Feedback