Arthritis tied to excess risk for preterm delivery

  • Smith CJF & al.
  • Arthritis Care Res (Hoboken)
  • 21 Aug 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Women with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) may have an increased risk for preterm delivery (PTD).
  • Excess risk may be partly driven by disease activity in RA, and corticosteroid use in both RA and JIA.

Why this matters

  • Careful monitoring is warranted during pregnancy.

Study design

  • Prospective study of 657 women with RA, 170 with JIA, and 564 women without autoimmune disease.
  • Women were enrolled prior to 19 weeks' gestation by the Organization of Teratology Information Specialists Autoimmune Disease in Pregnancy Project.
  • Factors affecting PTD were obtained from medical records.
  • Funding: AbbVie; Amgen; Bristol-Myers Squibb; Pfizer; numerous other industry sponsors; NIH.

Key results

  • RA and JIA groups had elevated risk for PTD (risk ratio [RR], 2.09 [95% CI, 1.50-2.91] and 1.81 [95% CI, 1.14-2.89], respectively) relative to control group.
  • PTD was associated with active RA at enrollment (adjusted RR [aRR], 1.58; 95% CI, 1.10-2.27) and anytime during pregnancy (aRR, 1.52; 95% CI, 1.06-2.18) vs inactive RA.
  • PTD was not associated with active JIA vs inactive JIA.
  • For both RA and JIA groups, PTD was associated with corticosteroid use in every trimester, independent of disease activity; aRRs were significant, ranging from about 2 to 5.

Limitations

  • Small number of PTDs.
  • Small number of JIA pregnancies.

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