Session Type: Abstract Submissions (ACR)
Background/Purpose: Juvenile idiopathic arthritis (JIA) most often affects women before childbearing age. Patients with JIA and their parents often ask about the potential impact of the disease on future pregnancies. Little is known about the risk of obstetrical complications in women with JIA. In a large population-based study, we aimed to determine if women with JIA have an increased risk of obstetrical complications compared to women without JIA.
Methods: We identified all women who had a hospitalization for their first delivery after JIA diagnosis using Quebec’s physician billing and hospitalization databases (1996-2008). Women were defined as JIA cases if they had ≥ 1 hospitalization with the International Classification of Diseases, Ninth Revision(ICD-9) code 714, as a primary or secondary diagnosis, or ≥ 2 physician visits with the ICD-9 code 714, occurring 2 months to 2 years apart, both prior to the age of 18 years and prior to the delivery. We randomly selected a general population control group, composed of women with their first delivery and matched at least 3:1 for age and year of delivery, without a preceding diagnosis of JIA.
We ascertained the length of hospitalization for delivery, the occurrence of gestational diabetes, premature rupture of membranes (PROM), preeclampsia/eclampsia, and caesarean section (c-section), at the time of hospitalization for delivery, based on relevant diagnostic or procedures codes.
Results: We identified 1406 women with JIA. Of these women, 90 had their first delivery after JIA diagnosis, during database follow-up, and were matched to 448 controls. Mean age at JIA diagnosis was 15.3 years (95% CI 14.8, 15.8) and mean age at delivery was 22.9 years (95% CI 22.3, 23.5). There was no difference in the length of hospitalization for delivery between women with JIA and controls [3.2 days (95% CI 2.9, 3.5) vs 2.8 days (95% CI 2.7, 3.0)]. Compared to controls, women with JIA did not experience more gestational diabetes [1.1% (95% CI 0.1, 6.9) vs 1.1% (95% CI 0.4, 2.7)], PROM [8.9% (95% CI 4.2, 17.3) vs 8.3% (95% CI 6.0, 11.3)], preeclampsia/eclampsia [3.3% (95% CI 0.9, 10.1) vs 4.7% (95% CI 3.0, 7.2)], or c-section [20.0% (95% CI 12.6, 30.0) vs 20.5% (95% CI 17.0, 24.6)].
Conclusion: Our findings suggest that women with JIA do not seem to have an increased risk of obstetrical complications compared to the general population. We are currently expanding this study by performing mother-child linkage to further assess neonatal outcomes in children born to women with JIA and their controls.
C. A. Pineau,
A. E. Clarke,
C. M. Duffy,
D. E. Feldman,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/obstetrical-complications-in-women-with-juvenile-idiopathic-arthritis/