Background/Purpose: Although there is a higher frequency of adverse maternal outcomes in mother with rheumatoid arthritis, little is known regarding mothers with juvenile idiopathic arthritis (JIA). Our objective was to determine whether women with a history of JIA have more adverse maternal outcomes than mothers who never had JIA.  

Methods:

Our cohort study used data from physician billing and hospitalizations covering Québec, Canada. We identified all females with JIA with a first-time birth between 01/01/1983 and 12/31/2010, and assembled a control cohort of first-time mothers without JIA from the same administrative data, matching 4:1 for date of first birth, maternal age and area of residence. We compared maternal outcomes (hypertension, diabetes, preeclampsia/eclampsia) in the JIA versus non-JIA groups, using logistic regression. We adjusted for maternal education, and socioeconomic status (as measured by a geographic deprivation index).

Results:

Mean age at delivery was 24.7 years in the JIA group (n=1681) and 25.0 for the non-JIA group (n=6724). Mothers with JIA were more likely to have hypertension during pregnancy compared with those who did not have JIA (8.5% (95% confidence interval (CI) 7.3,9.9) vs 4.6%, 95% CI 4.2,5.2 ). The proportion in the JIA group with preeclampsia/eclampsia  was 3.8% (95% CI 2.9,4.8)vs 2.8% (95% CI  2.4,3.2 ) in the non JIA group and the proportion with diabetes during pregnancy was 0.9% (95% CI 0.5,1.5 ) in the JIA group vs 0.6% in the non JIA group (95% CI 0.4,0.8). Among JIA mothers, 99% who had hypertension during pregnancy also had pre-pregnancy hypertension compared with 57% in the non JIA group. Similarly, 100% who had diabetes during pregnancy had pre-pregnancy diabetes in the JIA group vs. 63% in the non JIA group.  In multivariate analyses, women with JIA were more likely to have hypertension during pregnancy (odds ratio (OR) 1.89, 95% confidence interval (CI) 1.55,2.28), but not preeclampsia/eclampsia (OR 1.06, 95% CI 0.80,1.42) compared to control women; the OR for diabetes during pregnancy (1.66, 95% CI 0.91,3.02) was inconclusive.   Lower socioeconomic status was associated with all three adverse maternal outcomes in the entire group. 

Conclusion:

Mothers with JIA were more likely to have hypertension during pregnancy compared to women without JIA. Further studies would be useful to assess the impact of medications and other factors (e.g. obesity) on maternal outcomes in JIA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-comparison-of-maternal-outcomes-in-women-with-and-without-juvenile-idiopathic-arthritis/