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Pregnancy outcomes in women with rheumatoid arthritis: a retrospective population-based cohort study.

Authors
  • Aljary, Hissah1
  • Czuzoj-Shulman, Nicholas2
  • Spence, Andrea R2
  • Abenhaim, Haim A1, 2
  • 1 Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University Montreal, Montreal, Canada. , (Canada)
  • 2 Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute, Jewish General Hospital, Montreal, Canada. , (Canada)
Type
Published Article
Journal
The Journal of Maternal-Fetal & Neonatal Medicine
Publisher
Informa UK (Taylor & Francis)
Publication Date
Feb 01, 2020
Volume
33
Issue
4
Pages
618–624
Identifiers
DOI: 10.1080/14767058.2018.1498835
PMID: 30189769
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Purpose: To assess if pregnancies in women with rheumatoid arthritis (RA) are at a higher risk for adverse maternal and neonatal outcomes.Materials and methods: A retrospective cohort study was carried out using the Healthcare Cost and Utilization Project - National Inpatient Sample (HCUP-NIS) from the USA. All births that took place from 2004 to 2013 were identified and women were classified as having RA or not on the basis of ICD-9 coding. Unconditional logistic regression was used to evaluate the adjusted effect of RA on maternal and neonatal outcomes.Results: Of the total 8,417,607 births in our cohort, 6068 were among women with RA for an overall prevalence of 72 per 100,000 births. There was a steady increase in reported RA in pregnancy from 47 to 100 per 100,000 over the 10-year study period. Compared with women without RA, women with RA were more likely to develop pre-eclampsia/eclampsia, gestational diabetes, to present with preterm premature rupture of membranes(PPROM), to experience placental abruption and placenta previa, and to deliver by caesarean section. Postpartum, RA-complicated pregnancies were associated with wound complications and thromboembolisms. Congenital anomalies, small for gestational age and preterm birth were more common in neonates of women with RA.Conclusion: RA in pregnancy is associated with a greater likelihood of adverse maternal and neonatal outcomes. Women with RA should be made aware of these risks and be followed as a high risk pregnancy.

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