Objective: To add to data on adverse birth outcomes accounting for disease activity in women with psoriatic arthritis (PsA) and ankylosing spondylitis (AS).
Methods: Data were analyzed from women enrolled in the Organization of Teratology Information Specialists (OTIS) Autoimmune Disease Project from 2004-2018. Disease activity was measured by the Health Assessment Questionnaire (HAQ) or Routine Assessment of Patient Index Data 3 (RAPID3). Poisson regression was used to estimate adjusted risk ratios (aRR) with 95% Confidence Intervals (CI) for selected adverse pregnancy outcomes.
Results: Compared to healthy controls (n=717), PsA (n = 117) was associated with increased risk for moderate preterm delivery (32-36 weeks' gestation) (aRR 1.81, 95% CI 1.01-3.26), oligohydramnios (aRR 3.79, 95% CI 1.34-10.74), and Caesarean delivery (aRR 1.63, 95% CI 1.26-2.12). Women with AS (n = 129) had an increased risk of delivering infants requiring intensive care (aRR 1.67, 95% CI 1.05-2.67). High 32 week HAQ score was associated with preterm delivery in women with PsA (aRR 3.82, 95% CI 1.51-9.67). In women with AS, high RAPID3 score was associated with Caesarian delivery (aRR 5.82, 95% 1.06-31.78), and 2nd trimester corticosteroid use was associated with preterm delivery (aRR 4.41, 95% CI 1.57-12.41).
Conclusion: Women with PsA and AS have increased risk for selected adverse pregnancy outcomes. Active disease and corticosteroid use may increase the risk for some adverse pregnancy outcomes in women with these conditions. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Conflict of interest statement
Conflicts of Interest
The authors do not have any conflicts of interest to declare.
Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project.J Rheumatol. 2015 Aug;42(8):1376-82. doi: 10.3899/jrheum.140583. Epub 2015 Apr 15. J Rheumatol. 2015. PMID: 25877497
Factors Associated With Preterm Delivery Among Women With Rheumatoid Arthritis and Women With Juvenile Idiopathic Arthritis.Arthritis Care Res (Hoboken). 2019 Aug;71(8):1019-1027. doi: 10.1002/acr.23730. Epub 2019 Jul 4. Arthritis Care Res (Hoboken). 2019. PMID: 30133181
Association Between Pregnancy and Perinatal Outcomes Among Women With Epilepsy.JAMA Neurol. 2017 Aug 1;74(8):983-991. doi: 10.1001/jamaneurol.2017.1310. JAMA Neurol. 2017. PMID: 28672292 Free PMC article.
Oxytocin receptor antagonists for inhibiting preterm labour.Cochrane Database Syst Rev. 2014 Jun 6;(6):CD004452. doi: 10.1002/14651858.CD004452.pub3. Cochrane Database Syst Rev. 2014. PMID: 24903678 Review.
Safety of topical corticosteroids in pregnancy.Cochrane Database Syst Rev. 2015 Oct 26;(10):CD007346. doi: 10.1002/14651858.CD007346.pub3. Cochrane Database Syst Rev. 2015. PMID: 26497573 Review.
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