Does Rheumatoid Arthritis Really Improve During Pregnancy? A Systematic Review and Metaanalysis

J Rheumatol. 2019 Mar;46(3):245-250. doi: 10.3899/jrheum.180226. Epub 2018 Nov 1.

Abstract

Objective: We performed a systematic review and metaanalysis to assess rheumatoid arthritis (RA) disease activity during pregnancy using objective disease activity scoring systems.

Methods: A systematic review of PubMed, EMBASE/Medline, Cochrane, and LactMed databases was performed. Our inclusion criteria for analysis were prospective studies, more than 5 patients per study, and data on RA using an objective scoring system conducted by a clinician/health professional.

Results: Ten studies were eligible for final analysis, which included 237 patients, of which prepartum data were available for 204 patients. Postpartum disease activity was recorded in 135 pregnancies.

Conclusion: Disease activity improved in 60% of patients with RA in pregnancy and flared in 46.7% postpartum.

Keywords: DISEASE ACTIVITY; INFLAMMATORY ARTHRITIS; PREGNANCY; PROSPECTIVE; RHEUMATOID ARTHRITIS.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / physiopathology*
  • C-Reactive Protein / analysis
  • Female
  • Humans
  • Postpartum Period
  • Pregnancy*
  • Prospective Studies
  • Recurrence
  • Severity of Illness Index

Substances

  • Antirheumatic Agents
  • C-Reactive Protein