Obstetric Outcomes in Younger Women Less Than 21 Years of Age Compared to Women Between Age 21 and 25 Years with Rheumatic Disease

Chelsey Smith¹, Christina Chambers¹, Rebecca Baer², Laura Jelliffe-Pawlowski³ and Gretchen Bandoli¹, ¹University of California San Diego, La Jolla, CA, ²University of California San Diego, La Jolla, ³University of California San Francisco, San Francisco

Meeting: ACR Convergence 2020

Keywords: pregnancy, rheumatoid arthritis, Systemic lupus erythematosus (SLE)

Session Information

Date: Monday, November 9, 2020

Session Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: Poster Session D

Session Time: 9:00AM-11:00AM

Background/Purpose: Very young maternal age has been described as a risk factor for several adverse obstetric outcomes. This study aimed to investigate whether younger women with rheumatic diseases had differential risk for adverse obstetric outcomes compared to older age groups.

Methods: We queried a retrospective California birth cohort of 3 million singleton live births between 2011-2017 created from linked birth certificates and hospital discharge summaries. ICD-9/10 codes were used to classify women with rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and systemic lupus erythematosus (SLE). Outcomes of interest were preterm birth, very preterm birth, small for gestational age offspring, offspring requiring NICU admission, gestational diabetes, preeclampsia, and caesarean delivery. In multivariable log-linear regression, risk of each outcome was assessed in women less than 21 years of age compared to women between 21 and 25 years of age. Models were adjusted for maternal race/ethnicity, body mass index, payer source, anxiety, depression, bipolar disorder, smoking, drug abuse, alcohol abuse, and history of hypertension or diabetes. Risk ratios were first estimated for women with any rheumatic disease, and then repeated for women with RA/JIA or SLE.

Results: A total of 1,769 women 25 years or younger with any rheumatic disease were identified, with 394 under the age of 21. Women with any rheumatic condition under age 21 overall had a lower risk for caesarean delivery (aRR 0.67, 95% CI 0.55-0.81) and gestational diabetes (aRR 0.55, 95% CI 0.36-0.84) than women age 21-25. When analyzed by specific rheumatic disease, women with RA or JIA under age 21 had a higher risk for preterm birth (aRR 1.45, 95% CI 1.01-2.08) as compared to women age 21-25. This increased risk was not observed in very young women with SLE.

Conclusion: The majority of obstetric outcomes did not differ between very young women and women age 21-25 with rheumatic diseases. Risk of caesarean delivery and gestational diabetes may be decreased in younger women compared to older women with rheumatic diseases. Our study did suggest that for RA or JIA, younger age may be associated with a higher risk of preterm delivery.

Disclosure: C. Smith, None; C. Chambers, Amgen, Inc, 1, AstraZeneca, 1, Celgene, 1, GlaxoSmithKline, 1, Janssen Pharmaceuticals, 1, Pfizer, Inc, 1, Regeneron, 1, Hoffman La-Roche-Genentech, 1, Genzyme Sanofi-Aventis, 1, Takeda Pharmaceutical Company Limited, 1, Sanofi, 1, UCB Pharma, USA, 1, Sun Pharma Global FZE, 1, Gerber Foundation, 1; R. Baer, None; L. Jelliffe-Pawlowski, None; G. Bandoli, None.

To cite this abstract in AMA style:

Smith C, Chambers C, Baer R, Jelliffe-Pawlowski L, Bandoli G. Obstetric Outcomes in Younger Women Less Than 21 Years of Age Compared to Women Between Age 21 and 25 Years with Rheumatic Disease [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/obstetric-outcomes-in-younger-women-less-than-21-years-of-age-compared-to-women-between-age-21-and-25-years-with-rheumatic-disease/. Accessed January 15, 2021.

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