Hamroun, Sabrina; Hamroun, Aghilès; Bigna, Jean-Joël; Allado, Edem; Förger, Frauke; Molto, Anna (2022). Fertility and pregnancy outcomes in women with spondyloarthritis: a systematic review and meta-analysis. Rheumatology, 61(4), pp. 1314-1327. Oxford University Press 10.1093/rheumatology/keab589
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OBJECTIVE
To determine the impact of spondyloarthritis (SpA) and its treatments on fertility and pregnancy outcomes, as well as the impact of pregnancy on disease activity.
METHODS
A systematic review and meta-analyses were performed, including studies in women with SpA (axial (axSpA) and peripheral SpA, including psoriatic arthritis (PsA)). The heterogeneity between studies was quantified (I2), and in case of substantial heterogeneity, the results were reported in a narrative review.
RESULTS
Within 4397 eligible studies, 21 articles were included, assessing overall 3566 patients and 3718 pregnancies compared to 42264 controls. Fertility suffers from a lack of data in the literature. We found an increased risk of preterm birth (pooled OR 1,64 [1,15-2,33], I2 =24% in axSpA and 1,62 [1,23-2,15], I2 =0,0% in PsA), small for gestational age (pooled OR 2,05, [1,09-3,89], I2 =5,8% in axSpA), preeclampsia (pooled OR 1,59, [1,11-2,27], I2 =0% in axSpA) and caesarean section (pooled OR 1,70 [1,44-2,00], I2 =19,9% in axSpA and 1,71 [1,14-2,55], I2 =74,3% in PsA), without any other unfavourable pregnancy outcome. Further analysis showed a significant higher risk for elective caesarean (pooled OR 2,64, [1,92-3,62], I2 =0,0% in axSpA and 1,47, [1,15-1,88], I2 =0,0% in PsA), without increased risk for emergency caesarean in PsA. During pregnancy, there appears to be a tendency for unchanged or worsened disease activity in axSpA and unchanged or improved disease activity in PsA. Both conditions tend to flare in postpartum period.
CONCLUSION
SpA seems to be associated with an increased risk of preterm birth, small for gestational age, preeclampsia, and caesarean section.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology |
UniBE Contributor: |
Förger, Frauke |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1462-0324 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Brigitte Isenschmid |
Date Deposited: |
03 Dec 2021 17:24 |
Last Modified: |
05 Dec 2022 15:55 |
Publisher DOI: |
10.1093/rheumatology/keab589 |
PubMed ID: |
34297033 |
Uncontrolled Keywords: |
axial spondyloarthritis caesarean section disease activity fertility postpartum period pregnancy pregnancy outcomes psoriatic arthritis spondylarthropathies |
BORIS DOI: |
10.48350/161853 |
URI: |
https://boris.unibe.ch/id/eprint/161853 |
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