Skip to main content
SpringerLink
Log in

Pregnancy and rheumatic disease

A review of recent studies in rheumatoid arthritis and ankylosing spondylitis

  • Übersichten
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

The present paper reviews the results of recent investigations into the influence of pregnancy and sex hormones on rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Prospective patient studies have shown that pregnancy exerts a beneficial effect on the majority of RA patients, while AS patients generally have unchanged disease activity during gestation. In AS, gestational remission was confined to patients with accompanying diseases. A postpartum disease flare-up occurred commonly in both RA and AS. Blood parameters reflected mainly the biochemical changes of normal pregnancy. A decrease of circulating immune complexes has been found in RA patients remitting during pregnancy. No single serum factor or combination of serum factors responsible for gestational remission could be detected. The possible influence of α2-pregnancy-associated globulin on disease activity in pregnant patients remains contradictory. Hormonal contraceptives have been found to be protective against the manifestation of RA in four of five studies. However, no beneficial effect of sex hormones on the symptoms of established RA and AS could be demonstrated.

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. Allebeck P, Ahlborn A, Ljungstrøm K, Allander E (1983) Do oral contraceptives prevent rheumatoid arthritis x. European Congress of Rheumatology, Abstract 61

  2. Bohn H, Bauer HW (1981) Pregnancy-associated α2-glycoprotein (α2-PAG): Importance of its determination in malignant diseases. Med Lab 9:27–34

    Google Scholar 

  3. Bulmash JM (1979) Rheumatoid arthritis and pregnancy. Obstet Gynecol Ann 8:223–276

    Google Scholar 

  4. Cecere PA, Persellin RH (1981) The interaction of pregnancy and the rheumatic diseases. Clin Rheum Dis 7:747–768

    Google Scholar 

  5. Hadorn R (1975) Sexe, grossesse et alloantigenes (HL-A), bases d'une classification des maladies rheumatismales (Apropos de 30 grossesses dans la pelvispondylitis rheumatismale). Med Hyg 33:557–562

    Google Scholar 

  6. Hart FD, Bell ACH, Organe GSW (1951) Pregnancy in ankylosing spondylitis: A report of 2 cases. Ann Rheum Dis 9:54–60

    Google Scholar 

  7. Hart FD (1980) Bechterew's syndrome in women: is it different from that in men? Scand J Rheumatol [Suppl 32]:38–40

    Google Scholar 

  8. Hench PS (1938) The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrosis and intermittent hydarthrosis. Proc Mayo Clin 13:161–167

    Google Scholar 

  9. Hench PS, Kendall EC, Slocumb CH et al. (1950) Effects of cortisone acetate and pituitary ACTH on rheumatoid arthritis, rheumatic fever and certain other conditions: A study in clinical physiology. Arch Intern Med 85:545–566

    Google Scholar 

  10. Latman NS (1983) Relation of menstrual cycle phase to symptoms of rheumatoid arthritis. Am J Med 74:957–960

    Google Scholar 

  11. Linos A, O'Fallon WM, Worthington JW, Kurland LT (1983) Case-control study of rheumatoid arthritis and prior use of oral contraceptives. Lancet 1:1299–1300

    Google Scholar 

  12. Mishell DR (1982) Noncontraceptive health benefits of oral steroidal contraceptives. Am J Obstet Gynecol 142:809–816

    Google Scholar 

  13. Østensen M, Husby G (1981) Graviditet og revmatisk sykdom. Tidsskr Nor Lægeforen 101:1503–1506

    Google Scholar 

  14. Østensen M, Romberg Ø, Husby G (1982) Ankylosing spondylitis and motherhood. Arthritis Rheum 25:140–143

    Google Scholar 

  15. Østensen M, Aune B, Husby G (1983) Effect of pregnancy and hormonal changes on the activity of rheumatoid arthritis. Scand J Rheumatol 12:64–72

    Google Scholar 

  16. Østensen M, Husby G (1983) A prospective clinical study of the effect of pregnancy on rheumatoid arthritis. Arthritis Rheum 26:1155–1159

    Google Scholar 

  17. Østensen M (1984) The influence of pregnancy on blood parameters in patients with rheumatic disease. A prospective study. Scand J Rheumatol (In press)

  18. Østensen M, Lundgren R, Husby G, Rekvig OP (1983) Studies on hormonal immunity in pregnancy: Immunoglobulins, alloantibodies and autoantibodies in healthy pregnant women and in pregnant women with rheumatoid disease. J Clin Lab Immunol 11:143–147

    Google Scholar 

  19. Østensen M, Mørland B, Husby G (1983) Stimulation of muring macrophage Cathepsin B by serum from patients with rheumatoid arthritis: an indicator of disease activity. Clin Exp Immunol 51:103–109

    Google Scholar 

  20. Østensen M, von Schoultz B, Husby G (1984) Comparison between serum α2-pregnancy associated globulin and activity of rheumatoid arthritis and ankylosing spondylitis during pregnancy. Scand J Rheumatol 12, 315–318

    Google Scholar 

  21. Oka M (1958) Activity of rheumatoid arthritis and plasma 17-hydroxy-corticosteroids during pregnancy and following parturition. Acta Rheum Scand 4:243–248

    Google Scholar 

  22. Oka M, Vainio U (1966) Effect of pregnancy on the prognosis and serology of rheumatoid arthritis. Acta Rheum Scand 12:47–52

    Google Scholar 

  23. Ott VR, Frenzl V, Schmidt KL (1978) Rheumatismus und Schwangerschaft. Therapiewoche 28, 6696–6711

    Google Scholar 

  24. Persellin RH (1981) Inhibitors of inflammatory and immune responses in pregnancy serum. Clin Rheum Dis 7:769–780

    Google Scholar 

  25. Persellin RH, Rhodes J (1981) Inhibition of human monocyte Fc receptor and HLA-DR antigen expression by pregnancy α2-glycoprotein. Clin Exp Immunol 46:350–354

    Google Scholar 

  26. Persellin RH, Wiginton DAF, Rutstein JE, Cohen MJ, Homer R, Goehrs R, Steele AD, Philips VK, Kradel RP (1982) Pregnancy alpha-glycoprotein (PAG) and rheumatoid arthritis (RA) activity: A prospective analysis during gestation. Arthritis Rheum 25 [suppl]:S6

  27. Pope RM, Yoshiuoya S, Rutstein J, Persellin RH (1983) Effect of pregnancy on immune complexes and rheumatoid factors in patients with rheumatoid arthritis. Am J Med 74:973–979

    Google Scholar 

  28. Rössner B, Wessel G, Inder AUA, Jaeckel R, Römhild N, Keitel W, Hoffmann H, Weber G, Wenz W, Bartuschka B, Aktus R, Wasser M, Tanner E, Zielke A, Lindau P (1979) Beeinflussung durch Klimakterium, Schwangerschaften, Stillperioden und Ovulationshemmer. Beitr Rheumatol 23:57–73

    Google Scholar 

  29. Rudge SR, Kowanko JC, Drury PL (1983) Menstrual cyclicity of finger joint size and grip strength in patients with rheumatoid arthritis. Ann Rheum Dis 425–430

  30. Sany J, Clot J, Bonneau M, Andary M (1982) Immunomodulating effect of human placenta-eluted gamma globulins in rheumatoid arthritis. Arthritis Rheum 25:17–24

    Google Scholar 

  31. Smith WD, West HF (1960) Pregnancy and rheumatoid arthritis. Acta Rheum Scand 6:198–201

    Google Scholar 

  32. Stites DP, Pavia CS, Clemens LE, Kuhn RW, Siiteri PK (1979) Immunologic regulation in pregnancy. Arthritis Rheum 22:1300–1307

    Google Scholar 

  33. Unger A, Kay A, Griffin AJ, Panayi GS (1983) Disease activity and pregnancy-associated α1-glycoprotein in rheumatoid arthritis during pregnancy. Br Med J 286:750–752

    Google Scholar 

  34. Vandenbroucke JP, Valkenburg HA, Boersma JW, Cats A, Festen JJM, Huber-Bruning O, Rasker JJ (1982) Oral contraceptives and rheumatoid arthritis: further evidence for a preventive effect. Lancet II:839–842

    Google Scholar 

  35. White P (1953) Spondylitis ankylopoetica in the female. 8th Congrès Internationale de Maladies Rhumatismales, Geneva: Commun 944

  36. Wingrave SJ, Kay CR (1978) Reduction in incidence of rheumatoid arthritis associated with oral contraceptives. Lancet 1:569–511

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rheumatology, Institute of Clinical Medicine, University of Tromsø, Norway

    M. Østensen M.D. & G. Husby

Authors
  1. M. Østensen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Husby
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Østensen, M., Husby, G. Pregnancy and rheumatic disease. Klin Wochenschr 62, 891–895 (1984). https://doi.org/10.1007/BF01727437

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01727437

Key words

Search

Navigation