Session Information
Date: Sunday, November 13, 2016
Title: Epidemiology and Public Health I: Inflammatory Arthritis – Risk and Impact
Session Type: ACR Concurrent Abstract Session
Session Time: 4:30PM-6:00PM
Background/Purpose: The impact of inflammatory arthritis (IA) including rheumatoid (RA), psoriatic (PsA), and spondyloarthritis (SpA) on maternal, obstetrical and neonatal outcomes is not well described at the population level. Accordingly, we compared maternal and neonatal outcomes of women with and without IA in a contemporary pregnancy-birth cohort in a defined geographic area (province of Alberta, Canada) with universal health care.
Methods: The patient population consisted of 316,458 women who delivered singleton, live babies between 01/01/05 and 12/31/2014. Only the first birth for each woman during the study time period was included in the analysis. Previously established International Classification of Disease (ICD) version 9 or 10 was used to identify women with IA. A woman was considered to have IA if the diagnosis was present in a hospitalization, or in two outpatient records within 2 years that were at least 2 months apart. Women with IA were further categorized as RA and other IA . Other IA included psoriatic arthritis, spondyloarthritis, and reactive arthritis. Psoriasis patients were included in “other IA” due to the overlapping ICD 9/10 codes between PsO and PsA.
Results: There were 577 women with RA; 2281 with other IA; and 313600 with neither. Although statistically significantly different, maternal age did not differ substantially across groups (Table 1). Babies of women with RA were more likely to be small for gestational age (SGA). Maternal and neonatal outcomes in the other IA group were similar to those in women with neither disease (no IA). Rates of caesarean section and preterm delivery were significantly higher among women with RA (Table 1).
Conclusion: Our study provides novel data on the prevalence of RA and other IA in a contemporary cohort of pregnant women. We find that RA is associated with a higher likelihood of undergoing a caesarean section, preterm delivery and of having an SGA infant; however, other IA had no impact on maternal and neonatal outcomes. Our study highlights the need for peripartum counselling of women with RA.
| Neonatal Outcome | No Inflammatory Arthritis | Rheumatoid Arthritis | Other Inflammatory Arthritis | P-value |
| Mean Maternal Age (years) (SD) | 28.6 (5.6) | 29.9 (5.7) | 29.4 (5.4) | <0.0001 |
| Mean Birthweight (grams) (SD) | 3335.7 (565.6) | 3203.1 (592.8) | 3348.5 (563.0) | <0.0001 |
| Small for gestational age (SGA) (n (%)) | 37826 (12.1%) | 93 (16.1%) | 261 (11.5%) | 0.0074 |
| Preterm Delivery (< 37 weeks) (n (%)) | 22779 (7.3%) | 85 (14.7%) | 170 (7.5%) | <0.0001 |
| Caesarean section (n (%)) | 87956 (28.0) | 196 (34.0) | 665 (29.2) | <0.001 |
TABLE 1. Neonatal outcomes in Albertan women with “no inflammatory arthritis” (no IA), “rheumatoid arthritis” (RA) and “other inflammatory arthritis” (psoriatic arthritis, psoriasis, spondyloarthritis, reactive arthritis)
To cite this abstract in AMA style:
Keeling S, Savu A, Kaul P. The Impact of Inflammatory Arthritis (rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, reactive arthritis) on Maternal and Neonatal Outcomes: A Population-Level Analysis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-impact-of-inflammatory-arthritis-rheumatoid-arthritis-spondyloarthritis-psoriatic-arthritis-reactive-arthritis-on-maternal-and-neonatal-outcomes-a-population-level-analysis/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-impact-of-inflammatory-arthritis-rheumatoid-arthritis-spondyloarthritis-psoriatic-arthritis-reactive-arthritis-on-maternal-and-neonatal-outcomes-a-population-level-analysis/