Rheumatoid arthritis tied to higher risk for adverse pregnancy outcomes

  • Semin Arthritis Rheum

  • International Clinical Digest
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Takeaway

  • Women with rheumatoid arthritis (RA) may be at higher risk for several adverse pregnancy outcomes, according to an analysis of the largest inpatient database in the United States.

Why this matters

  • Women with RA should have close antenatal monitoring.

Study design

  • Inpatient pregnancy-related admissions were compared among women with (n=31,439) and without (n=42,286,209) RA in the US Nationwide Inpatient Sample.
  • Funding: None.

Key results

  • Women with RA (vs without RA) were at higher risk for:
    • hypertensive disorders (13.5% vs 8.9%; aOR, 1.16; P<.001>
    • premature rupture of the membranes (5.4% vs 3.4%; aOR, 1.5; P<.001>
    • antepartum hemorrhage (3% vs 2%; aOR, 1.23; P<.001>
    • preterm delivery (10.2% vs 6.6%; aOR, 1.46; P<.001>
    • intrauterine growth retardation (3.5% vs 1.8%; aOR, 1.93; P<.001 and>
    • cesarean section (35% vs 28%; aOR, 1.17; P<.001>
  • Women with RA (vs without RA) were at lower risk for postpartum hemorrhage (aOR, 0.77; P=.011).
  • Women with RA (vs without RA) have no excess mortality (P=.490).

Limitations

  • Cannot determine whether outcome was primary risk of hospitalization.
  • Causality cannot be inferred from analysis.

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