2024-01-22 14:10:33
Context
Rheumatoid arthritis (RA) can affect women of childbearing age. The management of patients with RA during pregnancy has evolved over the last decades, in particular with the availability of new therapeutic molecules.
Study objectives
To describe pregnancy in women with RA, compare pregnancy outcomes with those of women in the general population, and compare pregnancy outcomes in women with active and inactive RA.
Methods
Using the National Health Data System (SNDS), we identified all pregnancies ending between 2010 and 2020 in patients with or without RA. The characteristics of these pregnancies have been described. Active RA was defined by the initiation of a targeted synthetic/biological/therapeutic disease-modifying antirheumatic treatment, administration of systemic or intra-articular corticosteroids and/or RA-related hospitalization. Pregnancy outcomes were compared using a multivariable marginal logistic regression model using the generalized estimating equation (GEE).
Results
We included 11,792 RA pregnancies and 10,413,681 non-RA pregnancies. Among RA pregnancies, 74.5% ended in live births and 0.4% in stillbirths. RA-related pregnancies more frequently resulted in premature (adjusted OR (aOR) 1.84; 95% CI 1.69 to 2.00) and very preterm (aOR 1.43; 95% CI 1.20 to 2.00) births. 1.71), low birth weight (aOR 1.65; 95% CI: 1.52 to 1.90), cesarean section (aOR 1.46; 95% CI 1.38 to 1.55) and hospitalization related to pregnancy (aOR 1.30; 95% CI 1.22 to 1.39). Disease activity decreased during pregnancy. Rates of prematurity (aOR 2.02; 95% CI 1.71 to 2.38), small for gestational age (aOR 1.53; 95% CI 1.28 to 1.83) and cesarean section (aOR 1.25; 95% CI 1.11 to 1.40) were higher in patients with active RA than in patients with non-active RA.
Conclusion
Pregnancies among women with rheumatoid arthritis were associated with more adverse outcomes, particularly if the disease was active. These results should encourage doctors to closely monitor RA during this crucial period.
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#Pregnancy #outcomes #women #rheumatoid #arthritis