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Risk factors for adverse pregnancy outcomes in women with rheumatoid arthritis and follow-up of their offspring

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Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Objective

To explore the risk factors for adverse pregnancy outcomes (APOs) in women with rheumatoid arthritis (RA) and the influence on their offspring health.

Methods

Pregnant women with RA (n = 67) who were hospitalized in the Department of Obstetrics, Peking University People’s Hospital between January 2007 and September 2021 were included in this study. Participants were evaluated at least once in each trimester and postpartum. Fetal outcomes and RA disease activity were extracted from medical records, and the offspring of enrolled patients were followed up. Associations between RA disease activity, medication use, and pregnancy outcomes were analyzed.

Results

The incidence of APOs in our cohort was 43.3%. Postpartum hemorrhage (20.9%) was the commonest complication, followed by premature delivery (11.9%). Previous miscarriages [odds ratio (OR): 1.869, 95% confidence interval (CI): 1.053–3.318, P = 0.033] and antinuclear antibody (ANA) positivity (OR:3.168, 95% CI: 1.068–9.768, P = 0.045) were risk factors for APOs. Compared to patients with APOs, the remission rate of disease activity during pregnancy was higher in patients without APOs (P = 0.027). There were no significant differences between patients with and without APOs with respect to daily and cumulative doses of prednisone (P > 0.05). The average age of the offspring was 4.9 years (range 0.3–14 years). Long-term follow-up showed no significant differences in offspring health between the two groups (P > 0.05).

Conclusion

Previous miscarriages and ANA positivity are independent risk factors for APOs in RA patients, while adverse pregnancy outcomes and low-dose prednisone have no effect on offspring health.

Key points

• Previous miscarriages and ANA positivity are risk factors for APOs in RA patients.

• Adverse pregnancy outcomes and low-dose prednisone during pregnancy have no effect on offspring health.

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Funding

This work was supported by China International Medical Foundation (No. Z-2018–40-2101), Beijing Municipal Science and Technology Project (No. Z191100006619112), and Beijing Natural Science Foundation (No.7192211).

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China

    Liang Luo & Chun Li

  2. Department of Rehabilitation, Chongqing Rehabilitation Hospital of Integrated Traditional Chinese and Western Medicine, Chongqing, China

    Liang Luo

  3. Department of Rheumatology and Immunology, Chongqing University Three Gorges Hospital, Chongqing, China

    Xuerong Li

  4. Department of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, China

    Rui Yan

  5. Department of Rheumatology, Shexian Hospital, Handan, China

    Huijuan Zhang

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  1. Liang Luo
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Correspondence to Chun Li.

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Luo, L., Li, X., Yan, R. et al. Risk factors for adverse pregnancy outcomes in women with rheumatoid arthritis and follow-up of their offspring. Clin Rheumatol 41, 3135–3141 (2022). https://doi.org/10.1007/s10067-022-06233-9

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