Pregnancy Complications More Common in RA, Not Spondyloarthritis

February 25, 2020

A study of 312,081 pregnant women with rheumatoid arthritis, spondyloarthritis or no inflammatory arthritis, finds that women with rheumatoid arthritis are more likely to have pregnancy complications.

A study of 312,081 pregnant women with rheumatoid arthritis, spondyloarthritis or no inflammatory arthritis, finds that women with rheumatoid arthritis are more likely to have pregnancy complications.

In this study, women with rheumatoid arthritis (631 women) were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and small for gestational age babies (15.6%), compared to pregnant women with either spondyloarthritis (2,461 women) or no arthritis (308,989 women). The risk of adverse events were similar among women with and without spondyloarthritis.

The study, by Stephanie O. Keeling, et al., appears in this month's issue of The Journal of Rheumatology.

The researchers compared maternal and neonatal outcomes, comorbid conditions, and medication use among the three groups. Female patients with rheumatoid arthritis used significantly more nonsteroidal anti-inflammatory drugs and corticosteroids as compared to the other groups. The women with rheumatoid arthritis were more likely to have an infant of small gestational age or have hypertensive disorder in pregnancy as compared with women with spondyloarthritis or no arthritis.

PREGNANCIES IN WOMEN WITH SYSTEMIC SCLEROSIS

A systemic review and metaanalysis published in the September issue of The Journal of Rheumatology found that pregnancies in women with systemic sclerosis have a higher risk of miscarriages, preterm deliveries, and newborns with low birth weight. 

The findings are based on a search of studies published on pregnancies in women with systemic sclerosis between 1950 and 2018. While 461 studies were identified, 16 were ultimately included in the metaanalysis that showed pregnancies in systemic sclerosis patients were at higher risk of miscarriage (OR 1.6, 95% CI 1.22–2.22), fetuses with intrauterine growth retardation (IUGR; OR 3.2, 95% CI 2.21–4.53), preterm births (OR 2.4, 95% CI 1.14–4.86), and newborns with low birth weight (OR 3.8, 95% CI 2.16–6.56).

Patients also had a nearly three times higher risk of developing gestational hypertension (HTN; OR 2.8, 95% CI 2.28–3.39) and a 2.3 times higher chance of cesarean delivery compared to controls (OR 2.3, 95% CI 1.37–3.8).

During pregnancy, 14.3 percent of cases reviewed (44 of 307) reported patients with worsening or new disease manifestations during pregnancy and six months after giving birth (10.5 percent, or 32 of 306 cases).

REFERENCES

Stephanie O. Keeling, Samantha L. Bowker, Anamaria Savu and Padma Kaul. "A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes," The Journal of Rheumatology. February 2020. DOI: https://doi.org/10.3899/jrheum.181320

Jelena Blagojevic, Khitam Abdullah Alohaibi, et al. "Pregnancy in Systemic Sclerosis: Results of a Systematic Review and Metaanalysis,"Journal of Rheumatology. September 2019. DOI: https://doi.org/10.3899/jrheum.181460