ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2432

Peripartum Issues in the Inflammatory Arthritis (IA) Patient: A Survey of the Rapport (Rheumatoid Arthritis Pharmacovigilence Program and Outcomes Research in New Therapies) Registry

Tharindri Dissanayake1, Stephanie Keeling2 and Walter P. Maksymowych3, 1Department of Medicine, University of Alberta, Division of Rheumatology, Edmonton, AB, Canada, 2Department of Medicine, University of Alberta, University of Alberta, Edmonton, AB, Canada, 3CaRE Arthritis, Edmonton, AB, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: inflammatory arthritis, pregnancy, rheumatoid arthritis (RA) and therapy

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, October 23, 2018

Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: ACR Poster Session C

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

Background/Purpose:

Multiple issues surround the peripartum period for IA patients including medication use, risk of disease flare and potential impact on neonatal outcomes. We aimed to better understand these issues by surveying childbearing women with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in a biologic registry.

Methods:

A retrospective survey of 440 peripartum females of less than 50 years of age with RA or PsA in the RAPPORT registry was performed using an anonymous electronic-based RedCAp survey. Descriptive statistics and Fisher’s exact test were used to analyze the results.

Results:

162 patients (133 RA/29 PsA) completed the survey (103 women having 234 pregnancies), 164 pregnancies occurring before and 70 pregnancies occurring after IA diagnosis. Pregnancy outcomes from 103 patients included: 96% live births, 1.9% stillbirths, 23% miscarriages, and 15% therapeutic abortions. A third of patients had fewer children than desired due to IA disease activity, medications and other reasons. For 63 pregnancies after IA diagnosis: (1) 49% of pregnancies received pre-conception counseling; (2) most described good IA disease control during pregnancy but flared in the first 3 months postpartum; (3) 79% of pregnancies discontinued IA medications; (4) 35% of pregnancies occurred on biologic therapy at or prior to conception. Gestational age at time of delivery was 37-40 weeks in 58% (33/57) post-IA vs 66% (83/126) pre-IA diagnosis pregnancies. No statistically significant differences occurred between pregnancies before or after IA diagnosis for: pregnancy planning, fertility treatment, pregnancy and labour/delivery complications, birth defect frequency or neonatal complications. Neonatal ICU admissions were significantly lower in pre-IA diagnosis pregnancies compared to post-IA diagnosis pregnancies. No pregnancy complications were noted in 24/54 pregnancies on medications compared to 6/9 pregnancies not on medications.

Conclusion:

Women with RA and PsA are faced with multiple peripartum issues emphasizing the importance of informed decision-making before, during and after pregnancy.

Table 1. Characteristics of RAPPORT Survey Patients

Type of IA # (%)

RA

133 (82.1)

PsA

29 (17.8)

Age Range (years)

< 19

1 (0.6)

20-30

17 (10.5)

31-40

55 (34)

41-50

89 (36.4)

Antibodies # (%)

RF+

59 (36.4)

Anti-CCP +

6 (3.7)

RF & anti-CCP +

13 (8)

Do not recall

84 (51.9)

Pregnancy Outcomes # (%)

Live Births

99 (96)

Stillbirths

2 (1.9)

Miscarriages

23 (22.3)

Abortions

15 (14.5)

Total # pregnancies per patient # (%)

1

29 (27.2)

2

40 (38.8)

3

23 (22.3)

4

6 (5.8)

5-6

6 (5.8)

Table 2. Detailed Pregnancy Outcomes

All patients with pregnancies

Mean +/- SD

Patients with less children than desired (34/103)

Mean +/- SD

Patients with expected number of pregnancies (69/103)

Mean +/- SD

Total pregnancies

2.27 +/- 1.18

1.97 +/- 1.36

2.42 +/- 1.46

Live pregnancies

1.78 +/- 0.83

1.41 +/- 1.03

1.96 +/- 1.11

Stillbirths

0.03 +/- 0.14

0.03 +/- 0.41

0.02 +/- 0.08

Miscarriages

0.29 +/- 0.64

0.38 +/- 0.56

0.26 +/- 0.45

Therapeutic abortions

0.17 +/- 0.45

0.15 +/-0.49

0.19 +/- 0.49

Table 3. Pregnancy variables in pre-and post IA pregnancies

Number (%) of pregnancies prior to IA diagnosis

Number (%) of pregnancies post IA diagnosis

P value

Planed pregnancy

107 (69.9)

46 (73.0)

P=0.74

Time to pregnancy 0-2 months

49 (45.8)

19 (41.3)

P=0.72

Infertility treatment

13 (8.7)

2 (3.2)

P=0.24

37-40 weeks Gestational age at delivery

83 (65.8)

33 (57.9)

P=0.32

No pregnancy complications

86 (56.2)

30 (47.6)

P = 0.29

Labour and delivery complications

28 (22.2)

15 (26.3)

P =0.58

C-section Delivery

27 (21.3)

17 (29.8)

P=0.26

Low birth weight (<2.5kg)

6 (4.8)

4 (7.0)

P=0.50

Breast feeding

96 (76.2)

46 (80.7)

P=0.57

Birth defects

8 (6.3)

3 (5.5)

P=1.00

Neonatal medical complications

19 (15.1)

12 (21.8)

P=0.29

Neonatal ICU admissions

4 (3.2)

8 (14.5)

P=0.0082


Disclosure: T. Dissanayake, None; S. Keeling, None; W. P. Maksymowych, CaRE rthritis, 9.

To cite this abstract in AMA style:

Dissanayake T, Keeling S, Maksymowych WP. Peripartum Issues in the Inflammatory Arthritis (IA) Patient: A Survey of the Rapport (Rheumatoid Arthritis Pharmacovigilence Program and Outcomes Research in New Therapies) Registry [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/peripartum-issues-in-the-inflammatory-arthritis-ia-patient-a-survey-of-the-rapport-rheumatoid-arthritis-pharmacovigilence-program-and-outcomes-research-in-new-therapies-registry/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/peripartum-issues-in-the-inflammatory-arthritis-ia-patient-a-survey-of-the-rapport-rheumatoid-arthritis-pharmacovigilence-program-and-outcomes-research-in-new-therapies-registry/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology