Skip to main content

Advertisement

SpringerLink
Log in

Pregnancy Outcomes in Women with Rheumatoid Arthritis in Washington State

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Objective: To determine whether rheumatoid arthritis (RA) is associated with increased adverse obstetric or neonatal outcomes. Study design and setting: Washington State birth records and hospital discharge data between 1987 and 2001 identified a cohort of women with rheumatoid arthritis and a comparison group of women without rheumatoid arthritis. Pregnancy and neonatal outcomes were compared using general linear models for common outcomes, calculating approximate relative risks and 95% confidence intervals. Results: There were 243 women with rheumatoid arthritis and 2559 controls. Infants of women with rheumatoid arthritis had increased risk of cesarean delivery (adjusted approximate relative risk, aRR=1.66, 95% CI (1.22, 2.26)), prematurity (aRR=1.78, 95% CI (1.21, 2.60)), and longer birth hospitalization (aRR=1.86, 95% CI (1.32, 2.60)) compared to those born to women without rheumatoid arthritis. Conclusions: We speculate that the increased risks for cesarean delivery, prematurity, and longer hospitalization at birth among infants born to women with rheumatoid arthritis may be due to the pathophysiologic changes associated with rheumatoid arthritis or medications used to treat the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Wiles N, et al. Estimating the incidence of rheumatoid arthritis: Trying to hit a moving target? Arthritis Rheum 1999;42:1339–46.

    Article  PubMed  CAS  Google Scholar 

  2. Yasmeen S, et al. Pregnancy outcomes in women with systemic lupus erythematosus. J Matern Fetal Med 2001;10:91–6.

    Article  PubMed  CAS  Google Scholar 

  3. Wolfberg AJ, et al. Association of rheumatologic disease with preeclampsia. Obstet Gynecol 2004;103:1190–3.

    PubMed  Google Scholar 

  4. Skomsvoll JF, et al. Obstetrical and neonatal outcome in pregnant patients with rheumatic disease. Scand J Rheumatol Suppl 1998;107:109–12.

    PubMed  CAS  Google Scholar 

  5. Bowden AP, et al. Women with inflammatory polyarthritis have babies of lower birth weight. J Rheumatol 2001;28:355–9.

    PubMed  CAS  Google Scholar 

  6. Choy EH, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 2001;344:907–16.

    Article  PubMed  CAS  Google Scholar 

  7. al-Janadi M, et al. Cytokine profile in systemic lupus erythematosus, rheumatoid arthritis, and other rheumatic diseases. J Clin Immunol 1993;13:58–67.

    Article  PubMed  CAS  Google Scholar 

  8. Liou LB. Different monocyte reaction patterns in newly diagnosed, untreated rheumatoid arthritis and lupus patients probably confer disparate C-reactive protein levels. Clin Exp Rheumatol 2003;21:437–44.

    PubMed  CAS  Google Scholar 

  9. Yang PT, et al. Increased CCR4 expression on circulating CD4(+) T cells in ankylosing spondylitis, rheumatoid arthritis and lupus erythematosus. Clin Exp Immunol 2004;138:342–7.

    Article  PubMed  CAS  Google Scholar 

  10. Bernstein I, Gabbe SG. Intrauterine growth restriction in obstetrics. In: Gabbe SG, editor. Obstetrics: Normal and problem pregnancies. (3rd ed.) New York: Churchill Livingstone, 1996:863–4.

    Google Scholar 

  11. Williams RL, et al. Fetal growth and perinatal viability in California. Obstet Gynecol 1982;59:624–32.

    PubMed  CAS  Google Scholar 

  12. Zhang J, Yu K. What’s the relative risk?: A method to directly estimate risk rations in cohort studies of common outcomes. JAMA 1998;280:1690–1.

    Article  PubMed  CAS  Google Scholar 

  13. http://www.ats.ucla.edu/stat/stata/faq/relative risk.htm.

  14. Hung TH, et al. Secretion of tumor necrosis factor-alpha from human placental tissues induced by hypoxia-reoxygenation causes endothelial cell activation in vitro; a potential mediator of the inflammatory response in preeclampsia. Am J Pathol 2004;164:1049–61.

    PubMed  CAS  Google Scholar 

  15. Takacs P, et al. Increased vascular endothelial cell production of interleukin-6 in severe preeclampsia. Am J Obstet Gynecol 2003;188:740–4.

    Article  PubMed  CAS  Google Scholar 

  16. Ostensen M. The effect of pregnancy on ankylosing spondylitis, psoriatic arthritis, and juvenile rheumatoid arthritis. Am J Reprod Immunol 1992;28:235–7.

    PubMed  CAS  Google Scholar 

  17. Nelson LJ, Ostensen M. Pregnancy and rheumatoid arthritis. Rheum Dis Clin North Am 1997;23:195–212.

    Article  PubMed  CAS  Google Scholar 

  18. Reichman NE, Hade EM. Validation of birth certificate data. A study of women in New Jersey’s HealthStart program. Ann Epidemiol 2001;11:186–93.

    Article  PubMed  CAS  Google Scholar 

Download references

ACKNOWLEDGMENTS

The authors would like to thank the Washington State Department of Health for providing the data, and Drs. Beth Mueller, Cathy Critchlow, Lee Nelson, and Mr. Bill O’Brien for their assistance with the project. This research was supported in part by Project #T76 MC00011 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, U.S. Department of Health and Human Services.

Author information

Authors and Affiliations

  1. University of Washington, Seattle, Washington, USA

    Susan D. Reed MD, MPH, Teresa A. Vollan MPH & Megan A. Svec MPH

  2. Department of Obstetrics and Gynecology, University of Washington, Harborview Medical Center, Box 359865, 325 9th Avenue, Seattle, Washington, 98104-2499, USA

    Susan D. Reed MD, MPH

Authors
  1. Susan D. Reed MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Teresa A. Vollan MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Megan A. Svec MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan D. Reed MD, MPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reed, S.D., Vollan, T.A. & Svec, M.A. Pregnancy Outcomes in Women with Rheumatoid Arthritis in Washington State. Matern Child Health J 10, 361–366 (2006). https://doi.org/10.1007/s10995-006-0073-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-006-0073-3

Key Words

Search

Navigation