Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Nausea and Vomiting during Pregnancy (NVP) has been associated with a decreased risk for spontaneous abortion (SAB). However, the Th1/Th2 imbalance that occurs in pregnancy and is accentuated in women with NVP has not been studied in women with autoimmune diseases (AI) with respect to risk for SAB.
Methods: As part of the ongoing Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project, pregnant women were surveyed regarding 1st trimester vomiting using the Pregnancy Unique Quantification of Emesis (PUQE) questionnaire. Other characteristics assessed included maternal demographics, lifestyle factors and health status, AI status, current pregnancy related characteristics, pregnancy planning, previous pregnancy loss, and outcome of the current pregnancy. The severity of NVP was compared using the mean PUQE scores as well as categories of NVP. Cox proportional hazards regression models were constructed to estimate the adjusted hazard ratios for SAB in those with and without NVP. Separate models were constructed for women with and without AI.
Results: Data were available for 182 women with AI (n = 92) and without AI (n = 90). The mean age of the women at delivery was 33±5 years, with enrollment in the study taking place at an average gestational age of 9±3 weeks. The prevalence of NVP in the entire sample was 65%, with a mean PUQE score of 4.91±1.96. The overall crude rate of SAB was 11%; the rate in women with AI was 13% compared to 9% in those without AI. Women with AI had lower PUQE scores as compared to those without AI, although the difference was not statistically significant (4.7 vs. 5.1; p=0.14). The crude rate of SAB among those with NVP was 9% compared to 16% among those without NVP. The adjusted hazard ratio for SAB among women who had NVP compared to those who did not was 0.61 (95% CI, 0.23-1.62). The adjusted hazard ratios for SAB in women with NVP compared to those without were similar and close to 1 both in women with and without AI (95% CIs, 0.19-2.02 and 0.08-1.47, respectively).
Conclusion: The prevalence of NVP in this cohort of pregnant women with and without AI is comparable to the general population (65% compared to 60-90% in the general population). Women with NVP had a lower risk of SAB compared to those without NVP. The association between NVP and SAB did not differ appreciably between women with and without AI.
Disclosure:
B. Bharti,
None;
D. L. Johnson,
Abbott Laboratories,
2,
Amgen,
2,
UCB,
2,
Roche Genentech,
2,
Sanofi-Aventis Pharmaceutical,
2,
Bristol-Myers Squibb,
2,
Sandoz,
2,
Teva Pharmaceuticals,
2,
CSL,
2,
Apotex,
2,
Barr Laboratories, Inc.,
2,
Novartis Pharmaceutical Corporation,
2,
GSK,
2;
C. D. Chambers,
Abbott Laboratories,
2,
Amgen,
2,
UCB,
2,
Roche Genentech,
2,
Sanofi-Aventis Pharmaceutical,
2,
Bristol-Myers Squibb,
2,
Sandoz,
2,
Teva Pharmaceuticals,
2,
Parr ,
2,
Apotex,
2,
Barr Laboratories, Inc.,
2,
CSL,
2,
GSK,
2,
Novartis Pharmaceutical Corporation,
2.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/nausea-and-vomiting-during-pregnancy-and-spontaneous-abortion-in-women-with-rheumatoid-arthritis/