Background/Purpose: During pregnancy, BASDAI may reflect not only the activity of ankylosing spondylitis (AS), but also back pain and fatigue, that are associated with the pregnancy itself. Our objective wasto identify BASDAI components with the most optimal ratio of sensitivity and specificity to assess the activity of AS during pregnancy.

Methods: The study group included 50 pregnant women with AS (modified New York criteria, 1984). Mean age of patients was 31,6±4,2 years, and disease duration – 132,4±85,8 months. Additionally, 90 healthy pregnant women with no history of back pain and arthritis were surveyed, the average age in this group was 27,9±6,4 years. Of these, 51 women who were included in the control group had back pain in at least one trimester.

Control visits were scheduled at 10-11, 20-21, and 31-32 weeks of pregnancy. At each visit, all the women filled out the BASDAI. A ROC-analysis was performed with the calculation of the area under the curve (AUC) of each BASDAI component in each trimester of pregnancy.

Results: The AUC value for BASDAI in the 1st trimester was 0,74; the AUC of all BASDAI components exceeded 0,5 with a maximum value for the severity and duration of morning stiffness – 0,9 and 0,8, respectively, and with a minimum value for fatigue and back pain – 0,6 in each case. In the 2nd and 3rd trimesters, the AUC values for fatigue and back pain were less than 0,5, the AUC of morning stiffness components remained 0,8.

Conclusion: Morning stiffness has the highest classification value during pregnancy. Back pain and fatigue in the second half of pregnancy and BASDAI itself in the 3rd trimester are not sufficiently informative
for assessing the activity of AS.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-basdai-index-during-pregnancy/