High Rate of Preterm Birth in Pregnancies Complicated by Rheumatoid Arthritis

Abstract Objective To describe the outcomes of pregnancies complicated by rheumatoid arthritis (RA) and to estimate potential associations between disease characteristics and pregnancy outcomes. Study Design We reviewed all pregnancies complicated by RA delivered at our institution from June 2001 through June 2009. Fisher exact tests were used to calculate odds ratios. Univariable regression was performed using STATA 10.1 (StataCorp, College Station, TX). A p value of ≤ 0.05 was considered statistically significant. Results Forty-six pregnancies in 40 women were reviewed. Sixty percent of pregnancies had evidence of disease flare and 28% delivered prior to 37 weeks. We did not identify associations between preterm birth and active disease at conception or during pregnancy. In univariate analysis, discontinuation of medication because of pregnancy was associated with a significantly earlier gestational age at delivery (362/7 versus 383/7 weeks, p = 0.022). Conclusion Women with RA may be at higher risk for preterm delivery.

[1]  R. Jelsema.  Neonatal outcomes after demonstrated fetal lung maturity before 39 weeks of gestation. , 2011, Obstetrics and gynecology.

[2]  H. Sørensen,et al.  Rheumatoid arthritis and birth outcomes: a Danish and Swedish nationwide prevalence study , 2010, Journal of internal medicine.

[3]  E. Steegers,et al.  Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. , 2009, Arthritis and rheumatism.

[4]  B. Sibai,et al.  Timing of elective repeat cesarean delivery at term and neonatal outcomes. , 2009, The New England journal of medicine.

[5]  J. Hazes,et al.  Measuring disease activity and functionality during pregnancy in patients with rheumatoid arthritis. , 2007, Arthritis and rheumatism.

[6]  J. Giles,et al.  Rheumatoid arthritis and reproduction. , 2007, Rheumatic diseases clinics of North America.

[7]  Kenneth L. Jones,et al.  Are new agents used to treat rheumatoid arthritis safe to take during pregnancy? Organization of Teratology Information Specialists (OTIS) study. , 2007, Canadian family physician Medecin de famille canadien.

[8]  L. Finer,et al.  Perspectives on sexual and reproductive health , 2002 .

[9]  S. Reed,et al.  Pregnancy Outcomes in Women with Rheumatoid Arthritis in Washington State , 2006, Maternal and child health journal.

[10]  E. Chakravarty,et al.  Obstetric hospitalizations in the United States for women with systemic lupus erythematosus and rheumatoid arthritis. , 2006, Arthritis and rheumatism.

[11]  P. Villiger,et al.  Impact of pregnancy on health related quality of life evaluated prospectively in pregnant women with rheumatic diseases by the SF-36 health survey , 2005, Annals of the rheumatic diseases.

[12]  A. A. Drosos,et al.  Epidemiology of rheumatoid arthritis. , 2004, Autoimmunity reviews.

[13]  A. Silman,et al.  Women with inflammatory polyarthritis have babies of lower birth weight. , 2001, The Journal of rheumatology.

[14]  A. Silman,et al.  Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. , 1999, Arthritis and rheumatism.

[15]  J. Nelson,et al.  Pregnancy and rheumatoid arthritis. , 1997, Rheumatic diseases clinics of North America.

[16]  A. Silman,et al.  The incidence of rheumatoid arthritis in the United Kingdom: results from the Norfolk Arthritis Register. , 1994, British journal of rheumatology.

[17]  J. Forrest.  Epidemiology of unintended pregnancy and contraceptive use. , 1994, American journal of obstetrics and gynecology.

[18]  L. Shulman.  Increased risk of adverse pregnancy outcomes in women with rheumatoid arthritis: a nationwide population-based study , 2010 .

[19]  M. J. Penfold.  MANAGEMENT OF RHEUMATOID ARTHRITIS. , 1964, Nursing times.