Session Type: Poster Session D
Session Time: 8:30AM-10:30AM
Background/Purpose: Women with chronic rheumatic inflammatory diseases (CRID, i.e. rheumatoid arthritis (RA) or spondyloarthritis (SpA)) have been reported to have poorer pregnancy outcomes than the general population. The objective of this analysis was to describe the singleton pregnancy outcomes of women with CRID in France over the past decade.
Methods: This is a retrospective cohort study within the French Healthcare database (SNDS), which covers 97% of the French population. Adult women were included if they had RA or SpA according to CIM-10 codes, had started a singleton pregnancy between 2008 and 2017 (index date), and were continuously covered by this health insurance from 1‐year before pregnancy onset to 1-year after end of the pregnancy or death (whichever came first). Both maternal and pregnancy outcomes were considered. Outcomes were identified either by ICM-10 codes or hospital discharge summaries between 2008 and 2018.
Results: Among the 35,737 adult women with a CRID (40.7% with RA and 59.3% with SpA) and a past history of DMARD reimbursement, 11,274 (41.7%) started a singleton pregnancy during the study period. Among them, 6,501 (57.7%) were exposed to at least one DMARD preconceptionally (6 months before last menstrual period) and during pregnancy.
Mean (SD) age of women at the start of pregnancy was 32 (5) years, and disease duration was 4 (4) years. Live-birth represented by far the most frequent pregnancy outcome (76.9%), but 56.6% patients presented at least one unfavorable outcome among those listed in the table.
Conclusion: More than 75% pregnancies in patients with CRID resulted in a live-birth, but half of patients presented at least an unfavorable pregnancy outcome. Prevalence of miscarriage was lower than reported in the literature, probably reflecting the fact that very early miscarriages often do not need hospitalization/ specific intervention, and thus are difficult to identify in claims databases. Maternal and infant outcomes seemed comparable to general population. Whether medications had an impact on such outcomes needs further evaluation.
To cite this abstract in AMA style:Molto A, Roux B, Tran D, Ajrouche A, costedoat-Chalumeau n, Elefant E, Tsatsaris V, Fresson J, Bader-Meunier B, Fautrel B, Tubach F. More Than 50% of Women with Chronic Rheumatic Inflammatory Diseases Present an Unfavorable Pregnancy Outcome: A Descriptive Analysis of the National French Healthcare Database [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/more-than-50-of-women-with-chronic-rheumatic-inflammatory-diseases-present-an-unfavorable-pregnancy-outcome-a-descriptive-analysis-of-the-national-french-healthcare-database/. Accessed December 6, 2021.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/more-than-50-of-women-with-chronic-rheumatic-inflammatory-diseases-present-an-unfavorable-pregnancy-outcome-a-descriptive-analysis-of-the-national-french-healthcare-database/