Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Elevated rheumatoid arthritis disease activity and prednisone use during pregnancy are both associated with a lower bone mineral density (BMD) of the patients, but both can be inevitable in pregnant women with RA. It is unknown if these variables influence the BMD of their offspring. Our purpose was to investigate whether medication or disease activity during pregnancy in patients with RA, influence the BMD of their prepubertal offspring
Methods:
Children were included if their mother participated in a prospective cohort study on RA and pregnancy. In 108 children, approximately 7-years-old, the BMD was assessed by dual-energy X-ray absorptiometry. The bone mineral density was expressed in standard deviation score (SDS) for total body and lumbar spine. Variables of the child known to influence the BMD were taken into account: calcium intake, physical activity, serum 25-hydroxyvitamin D, gender, length and weight. Pre- and postnatal variables known to influence the BMD are gestational age, maternal smoking, birth weight, postnatal tempo of growth and type of feeding. The independent variables were prednisone, sulfasalazine and RA disease activity during pregnancy.
Results:
The mean BMD total body SDS was -0.11 (0.10) and the mean BMD lumbar spine SDS was -0.20 (0.99). Both variables were comparable to zero, thus the mean of aged and sexed matched healthy controls. No association was found between prednisone or RA disease activity during pregnancy and BMD of 7-years-old offspring, even after correcting for all known associated variables. Sulfasalazine had a positive effect on the whole body BMD (difference in SDS=0.53; p=0.005).
Conclusion:
Neither elevated RA disease activity nor medication use during pregnancy is associated with a lower BMD of the 7-year-old offspring. The results of this study may be a help in balancing the risk and benefits of prescribing medication during pregnancy versus accepting active disease.
Disclosure:
F. D. O. de Steenwinkel,
None;
A. C. S. Hokken-Koelega,
None;
J. Hazes,
None;
R. J. E. M. Dolhain,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/does-elevated-disease-activity-or-medication-use-influence-the-bone-density-of-the-prepubertal-offspring-in-pregnant-women-with-rheumatoid-arthritis/