Volume 31, Issue 149 (November & December 2023)                   J Adv Med Biomed Res 2023, 31(149): 549-556 | Back to browse issues page


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Sadeghi A, Rostami M, Nasiri N, Hatami R, Karimi Moghaddam A, Karimi Moghaddam Z et al . Adverse Pregnancy Outcomes and Rheumatoid Arthritis: a Retrospective Matched Cohort Study. J Adv Med Biomed Res 2023; 31 (149) :549-556
URL: http://journal.zums.ac.ir/article-1-7131-en.html
1- Dept. of Internal Medicine, School of Medicine, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
2- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
3- Dept. of Obstetrics and Gynecology, School of Medicine, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
4- Dept. of Ophthalmology, School of Medicine, Vali-E-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
5- Dept. of Radiation Oncology, School of Medicine, Vali-e-asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
6- Dept. of Emergency Medicine, School of Medicine, Valiasr-e-Asr Hospital, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran , zeraatchi.zums@gmail.com
Abstract:   (1296 Views)

Background and Objective: Rheumatoid Arthritis (RA) is an autoimmune-driven chronic systemic inflammatory disease. It could result in miscarriage, pre-eclampsia, and preterm labor, among other unfavorable pregnancy outcomes. Thus, this study was conducted to investigate the adverse pregnancy outcomes in pregnant women with RA.
Materials and Methods: Two cohorts of pregnant women with and without RA referred to the Ayatollah Mousavi Hospital's Gynecology and Obstetrics Clinic in Zanjan, Iran, during 2019-2020 were enrolled in a retrospective matched cohort study. Using their medical records, each participant completed a checklist of study variables. We used binary Logistic regression, chi-square test, Analysis of Variance, and independent samples t-test to analyze data using SPSS v.23.
Results: The study included 280 pregnant women. The mean age of the RA and control group (pregnant women without RA) was 32.4 ± 6.6 and 29.5 ± 6.7 years, respectively. The most prevalent adverse outcome was spontaneous abortion (54, 19.28%), which was significantly higher in the RA group (25% vs. 13.6%, P= 0.015). Cesarean section (24.3% vs. 10.7%, P= 0.003) and low birth weight (LBW) were both significantly higher in the RA group (15% vs. 5%, P= 0.005). RA increased the probability of spontaneous abortion, cesarean section, and LBW by more than 1.3 (odds ratio, 1.38; 95% CI, 0.45-5.46; P= 0.017), 2.2 (odds ratio, 2.24; 95% CI, 1.29-6.54; P =0.004), and 2.6 (odds ratio, 2.67; 95% CI, 1.86-7.05; P= 0.008) times, respectively.
Conclusion: Pregnant women with RA are more likely to experience spontaneous abortion, cesarean section, and having LBW infants comparing to pregnant women without RA.

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Pregnant women with RA are more likely to experience spontaneous abortion, cesarean section, and having LBW infants comparing to pregnant women without RA.


Type of Study: Original Article | Subject: Clinical medicine
Received: 2023/08/23 | Accepted: 2023/11/6 | Published: 2024/01/29

References
1. Favalli EG, Biggioggero M, Crotti C, Becciolini A, Raimondo MG, Meroni PL. Sex and management of rheumatoid arthritis. Clin Rev Allergy Immunol. 2019;56:333-45. [DOI:10.1007/s12016-018-8672-5] [PMID]
2. Nilsson J, Andersson MLE, Hafström I,et al . Influence of age and sex on disease course and treatment in rheumatoid arthritis. Open Access Rheumatol. 2021;13:123-38. [DOI:10.2147/OARRR.S306378] [PMID] [PMCID]
3. Littlejohn EA. Pregnancy and rheumatoid arthritis. Best Pract Res Clin Obstet Gynaecol. 2020;64:52-8. [DOI:10.1016/j.bpobgyn.2019.09.005] [PMID]
4. Förger F, Villiger PM. Immunological adaptations in pregnancy that modulate rheumatoid arthritis disease activity. Nat Rev Rheumatol. 2020;16:113-22. [DOI:10.1038/s41584-020-0394-4] [PMID]
5. Lin HC, Chen SF, Lin HC, Chen YH. Increased risk of adverse pregnancy outcomes in women with rheumatoid arthritis: a nationwide population-based study. Ann Rheum Dis. 2010;69:715-7. [DOI:10.1136/ard.2008.105262] [PMID]
6. Aljary H, Czuzoj-Shulman N, Spence AR, Abenhaim HA. Pregnancy outcomes in women with rheumatoid arthritis: a retrospective population-based cohort study. J Matern Fetal Neonatal Med. 2020;33:618-24. [DOI:10.1080/14767058.2018.1498835] [PMID]
7. Wallenius M, Skomsvoll JF, Irgens LM, et al. Postpartum onset of rheumatoid arthritis and other chronic arthritides: results from a patient register linked to a medical birth registry. Ann Rheum Dis. 2010;69:332-6. [DOI:10.1136/ard.2009.115964] [PMID]
8. Kishore S, Mittal V, Majithia V. Obstetric outcomes in women with rheumatoid arthritis: Results from Nationwide Inpatient Sample Database 2003-2011(✰). Semin Arthritis Rheum. 2019;49:236-40. [DOI:10.1016/j.semarthrit.2019.03.011] [PMID]
9. Jethwa H, Lam S, Smith C, Giles I. Does rheumatoid arthritis really improve during pregnancy? A systematic review and metaanalysis. J Rheumatol. 2019;46:245-50. [DOI:10.3899/jrheum.180226] [PMID]
10. Eisfeld H, Glimm AM, Burmester GR, Ohrndorf S, Backhaus M. Pregnancy outcome in women with different rheumatic diseases: a retrospective analysis. Scand J Rheumatol. 2021;50:299-306. [DOI:10.1080/03009742.2020.1849788] [PMID]
11. Huang W, Wu T, Jin T, et al. Maternal and fetal outcomes in pregnant women with rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol. 2023;42(3):855-70 [DOI:10.1007/s10067-022-06436-0] [PMID]
12. Bharti B, Lee SJ, Lindsay SP, et al. 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;42:1376-82. [DOI:10.3899/jrheum.140583] [PMID]
13. Al Rayes H, Abdulaziz S, Alotaibi AM, et al. Adverse impact of rheumatoid arthritis on pregnancy outcomes: A Saudi Arabia Prospective Multicenter Study. Open Access Rheumatol. 2021;13:167-75. [DOI:10.2147/OARRR.S315867] [PMID] [PMCID]
14. Barnabe C, Faris PD, Quan H. Canadian pregnancy outcomes in rheumatoid arthritis and systemic lupus erythematosus. Int J Rheumatol. 2011;2011:345727. [DOI:10.1155/2011/345727] [PMID] [PMCID]
15. Pósfai É, Bánhidy F, Urbán R, Czeizel AE. Birth outcomes of children born to women with rheumatoid arthritis. Cent Eur J Public Health. 2015;23:128-34. [DOI:10.21101/cejph.a3968] [PMID]
16. Nelson JL, Voigt LF, Koepsell TD, Dugowson CE, Daling JR. Pregnancy outcome in women with rheumatoid arthritis before disease onset. J Rheumatol. 1992;19:18-21.
17. Tsai YC, Chang HC, Chiou MJ, Luo SF, Kuo CF. Fetal-neonatal and maternal pregnancy outcomes in women with rheumatoid arthritis: a population-based cohort study. BMJ Open. 2022;12(10):e059203. [DOI:10.1136/bmjopen-2021-059203] [PMID] [PMCID]
18. de Man YA, Hazes JM, van der Heide H, et al. Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum. 2009;60(11):3196-206. [DOI:10.1002/art.24914] [PMID]
19. Krause ML, Makol A. Management of rheumatoid arthritis during pregnancy: challenges and solutions. Open Access Rheumatol. 2016;8:23-36. [DOI:10.2147/OARRR.S85340] [PMID] [PMCID]
20. Østensen M, Wallenius M. Fertility and pregnancy in rheumatoid arthritis. Indian J Rheumatol. 2016;11:122. [DOI:10.4103/0973-3698.194544]
21. Nørgaard M, Larsson H, Pedersen L, et al. Rheumatoid arthritis and birth outcomes: a Danish and Swedish nationwide prevalence study. J Intern Med. 2010;268:329-37. [DOI:10.1111/j.1365-2796.2010.02239.x] [PMID]
22. Siamopoulou-Mavridou A, Manoussakis MN, Mavridis AK, Moutsopoulos HM. Outcome of pregnancy in patients with autoimmune rheumatic disease before the disease onset. Ann Rheum Dis. 1988;47(12):982-7. [DOI:10.1136/ard.47.12.982] [PMID] [PMCID]
23. Silman AJ, Roman E, Beral V, Brown A. Adverse reproductive outcomes in women who subsequently develop rheumatoid arthritis. Ann Rheum Dis. 1988;47(12):979-81. [DOI:10.1136/ard.47.12.979] [PMID] [PMCID]
24. Camacho EM, Verstappen SM, Lunt M, Bunn DK, Symmons DP. Multiple adverse pregnancy outcomes before symptom onset are associated with a worse disease outcome in women with recent-onset inflammatory polyarthritis. Ann Rheum Dis. 2012;71(4):528-33. [DOI:10.1136/annrheumdis-2011-200292] [PMID]
25. Bortoluzzi A, Andreoli L, Carrara G, et al. Improved Pregnancy Outcome in Patients With Rheumatoid Arthritis Who Followed an Ideal Clinical Pathway. Arthritis Care Res (Hoboken). 2021;73:166-72. [DOI:10.1002/acr.24116] [PMID]

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