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Outcome of pregnancy in women with psoriatic arthritis compared to healthy controls

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Abstract

Objectives

The mean age at onset of psoriatic arthritis (PsA) ranges between the 4th–6th decades of life. However, little is known about fertility and pregnancy outcome in PsA patients. The aim of this study was to examine whether fertility and pregnancy outcome of PsA patients are different from healthy controls and to evaluate PsA and psoriasis disease activity perception during pregnancy and the year postpartum.

Methods

A questionnaire-based study, including demographic, fertility, pregnancy outcome, and disease activity questions, was conducted in PsA patients and healthy controls. The inclusion criterion was diagnosis of PsA before at least 1 pregnancy. Descriptive statistics are provided. T tests and Pearson chi-square tests were used to analyze the differences between continuous and categorical variables, respectively.

Results

The 74 PsA patients and 74 healthy controls were not significantly different in most of the demographic variables. The mean number of pregnancies, children, and infertility diagnosis were not significantly different between the groups. The pregnancy outcomes in the PsA group (n = 151) and in the control group (n = 189) were similar in: live birth (76% vs. 76%, P = 0.3), vaginal delivery (48% vs. 51%, P = 0.6), gestation age (38.5 vs. 38.3, P = 0.3), weight at birth (3.4 kg vs. 3.4 kg, P = 0.5), low rate of maternal and fetal complications, and the duration and rate of breastfeeding. Most (58%) patients reported favorable joint activity during pregnancy and 50% reported worsening during the 1st postpartum year.

Conclusions

PsA patients do not have more infertility or worse pregnancy outcomes compared to healthy controls.

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References

  1. Helmick CG, Lee-Han H, Hirsch SC, Baird TL, Bartlett CL (2014) Prevalence of psoriasis among adults in the U.S.: 2003–2006 and 2009–2010 National Health and Nutrition Examination Surveys. Am J Prev Med 47:37–45

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ogdie A, Langan S, Love T, Haynes K, Shin D, Seminara N, Mehta NN, Troxel A, Choi H, Gelfand JM (2013) Prevalence and treatment patterns of psoriatic arthritis in the UK. Rheumatology (Oxford) 52:568–575

    Article  Google Scholar 

  3. Husted JA, Thavaneswaran A, Chandran V, Eder L, Rosen CF, Cook RJ, Gladman DD (2011) Cardiovascular and other comorbidities in patients with psoriatic arthritis: a comparison with patients with psoriasis. Arthritis Care Res 63:1729–1735

    Article  Google Scholar 

  4. Gladman DD, Chandran V (2011) Observational cohort studies: lessons learnt from the University of Toronto Psoriatic Arthritis Program. Rheumatology (Oxford) 50:25–31

    Article  Google Scholar 

  5. Ritchlin CT, Colbert RA, Gladman DD (2017) Psoriatic arthritis. New Engl J Med 376:957–970

    Article  PubMed  Google Scholar 

  6. Kammer GM, Soter NA, Gibson DJ, Schur PH (1979) Psoriatic arthritis: a clinical, immunologic and HLA study of 100 patients. Semin Arthritis Rheum 9:75–97

    Article  PubMed  CAS  Google Scholar 

  7. Veale D, Rogers S, Fitzgerald O (1994) Classification of clinical subsets in psoriatic arthritis. Br J Rheumatol 33:133–138

    Article  PubMed  CAS  Google Scholar 

  8. Polachek A, Li S, Polachek IS, Chandran V, Gladman D (2017) Psoriatic arthritis disease activity during pregnancy and the first-year postpartum. Semin Arthritis Rheum 46:740–745

    Article  PubMed  Google Scholar 

  9. Ostensen M (1992) The effect of pregnancy on ankylosing spondylitis, psoriatic arthritis, and juvenile rheumatoid arthritis. Am J Reprod Immunol 28:235–237

    Article  PubMed  CAS  Google Scholar 

  10. Ostensen M (1988) Pregnancy in psoriatic arthritis. Scand J Rheumatol 17:67–70

    Article  PubMed  CAS  Google Scholar 

  11. Gladman DD, Thavaneswaran A, Chandran V, Zummer M (2012) Psoriatic arthritis (PsA) in Canadian Clinical Practice: the PsA Assessment in Rheumatology (PAIR). J Rheumatol 39:1850–1853

    Article  PubMed  Google Scholar 

  12. Østensen M (2017) Sexual and reproductive health in rheumatic disease. Nat Rev Rheumatol 13:485–493

    Article  PubMed  CAS  Google Scholar 

  13. Wallenius M, Skomsvoll JF, Irgens LM, Salvesen KÅ, Nordvåg BY, Koldingsnes W, Mikkelsen K, Kaufmann C, Kvien TK (2011) Fertility in women with chronic inflammatory arthritides. Rheumatology (Oxford) 50:1162–1167

    Article  Google Scholar 

  14. Clowse ME, Chakravarty E, Costenbader KH, Chambers C, Michaud K (2012) Effects of infertility, pregnancy loss, and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res (Hoboken) 64:668–674

    Article  Google Scholar 

  15. Ostensen M, Ostensen H (1998) Ankylosing spondylitis-the female aspect. J Rheumatol 25:120–124

    PubMed  CAS  Google Scholar 

  16. Wallenius M, Skomsvoll JF, Irgens LM, Salvesen KÅ, Nordvåg BY, Koldingsnes W, Mikkelsen K, Kaufmannm C, Kvien TK (2011) Pregnancy and delivery in women with chronic inflammatory arthritides with a specific focus on first birth. Arthritis Rheum 63:1534–1542

    Article  PubMed  Google Scholar 

  17. Mouyis MA, Thornton CC, Williams D, Giles IP (2017) Pregnancy outcome in patients with psoriatis arthritis. Rheumatol 44:128–129

    Google Scholar 

  18. Bröms G, Haerskjold A, Granath F, Kieler H, Pedersen L, Berglind IA (2018) Effect of maternal psoriasis on pregnancy and birth outcomes: a population-based cohort study from Denmark and Sweden. Acta Derm Venereol 98:728–734

    Article  PubMed  Google Scholar 

  19. Götestam SC, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C et al (2016) The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis 75:795–810

    Article  CAS  Google Scholar 

  20. Murase JE, Chan KK, Garite TJ, Cooper DM, Weinstein GD (2005) Hormonal effect on psoriasis in pregnancy and postpartum. Arch Dermatol 141:601–606

    Article  PubMed  CAS  Google Scholar 

  21. Holland D, Bretscher P, Russell AS (1984) Immunologic and inflammatory responses during pregnancy. J Clin Lab Immunol 14:177–179

    PubMed  CAS  Google Scholar 

  22. Nelson JL, Hughes KA, Smith AG, Nisperos BB, Branchaud AM, Hansen JA (1993) Maternal-fetal disparity in HLA class II alloantigens and the pregnancy-induced amelioration of rheumatoid arthritis. N Engl J Med 329:466–471

    Article  PubMed  CAS  Google Scholar 

  23. McHugh NJ, Laurent MR (1989) The effect of pregnancy on the onset of psoriatic arthritis. Br J Rheumatol 28:50–52.23

    Article  PubMed  CAS  Google Scholar 

  24. Thumboo J, Uramoto K, Shbeeb MI, O'Fallon WM, Crowson CS, Gibson LE et al (2002) Risk factors for the development of psoriatic arthritis: a population based nested case control study. Rheumatol 29:757–762

    Google Scholar 

  25. Eder L, Law T, Chandran V, Shanmugarajah S, Shen H, Rosen CF, Cook RJ, Gladman DD (2011) Association between environmental factors and onset of psoriatic arthritis in patients with psoriasis. Arthritis Care Res (Hoboken) 63:1091–1097

    Article  Google Scholar 

  26. Pattison E, Harrison BJ, Griffiths CE, Silman AJ, Bruce IN (2008) Environmental risk factors for the development of psoriatic arthritis: results from a case-control study. Ann Rheum Dis 67:672–676

    Article  PubMed  CAS  Google Scholar 

  27. Quigley MA, Hockley C, Davidson LL (2007) Agreement between hospital records and maternal recall of mode of delivery: evidence from 12 391 deliveries in the UK Millennium Cohort Study. BJOG 114:195–200

    Article  PubMed  CAS  Google Scholar 

  28. Amissah EA, Kancherla V, Ko YA, Li R (2017) Validation study of maternal recall on breastfeeding duration 6 years after childbirth. J Hum Lact 33:390–400

    Article  PubMed  Google Scholar 

  29. Olson JE, Shu XO, Ross JA, Pendergrass T, Robison LL (1997) Medical record validation of maternally reported birth characteristics and pregnancy-related events: a report from the Children’s Cancer Group. Am J Epidemiol 145:58–67

    Article  PubMed  CAS  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The University of Toronto Psoriatic Arthritis is supported by a grant from the Krembil Foundation. Dr. Polachek was supported by an unrestricted educational grant from Janssen Canada.

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Authors and Affiliations

  1. Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, University of Toronto, Toronto, Ontario, Canada

    Ari Polachek

  2. Department of Rheumatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Ari Polachek

  3. Reproductive life Stages Program, Women’s College Hospital, Toronto, Ontario, Canada

    Inbal Polachek Shlomi

  4. Beer Yaakov- Ness Ziona Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Inbal Polachek Shlomi

  5. TRIO Fertility, University of Toronto, Toronto, Ontario, Canada

    Karen Spitzer

  6. Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Disease, Toronto Western Hospital, Toronto, Ontario, Canada

    Daniel Pereira & Justine Yang Ye

  7. Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada

    Vinod Chandran & Dafna D. Gladman

  8. Departments of Medicine and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada

    Vinod Chandran

  9. Departments of Medicine (Rheumatology) and Obstetrics and Gynecology (REI), TRIO Fertility, University of Toronto, Toronto, Ontario, Canada

    Carl A. Laskin

  10. Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Disease, Toronto Western Hospital, 399 Bathurst Street 1E-410B, Toronto, Ontario, M5T 2S8, Canada

    Dafna D. Gladman

Authors
  1. Ari Polachek
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  2. Inbal Polachek Shlomi
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  3. Karen Spitzer
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  8. Dafna D. Gladman
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Correspondence to Dafna D. Gladman.

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Polachek, A., Polachek Shlomi, I., Spitzer, K. et al. Outcome of pregnancy in women with psoriatic arthritis compared to healthy controls. Clin Rheumatol 38, 895–902 (2019). https://doi.org/10.1007/s10067-018-4385-7

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  • DOI: https://doi.org/10.1007/s10067-018-4385-7

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