Increased risk of adverse pregnancy outcomes in women with rheumatoid arthritis: a nationwide population-based study
- 1School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
- 2Division of Rheumatology, Taipei Medical University Hospital, Taipei, Taiwan
- 3College of Medicine, Taipei Medical University, Taipei, Taiwan
- 4School of Public Health, Taipei Medical University, Taipei, Taiwan
- Dr Herng-Ching Lin, School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11 0,Taiwan;
- Accepted 17 April 2009
- Published Online First 29 April 2009
Objective Using a 3-year nationwide population-based database (2001–3), this study aims to examine the relationship between rheumatoid arthritis (RA) and adverse pregnancy outcomes, after adjusting for characteristics of infant, mother and father.
Methods The study used the Taiwan National Health Insurance Research Dataset and birth certificate registry. In total, 1912 mothers with RAand 9560 matched comparison mothers were included for analysis. Separate conditional logistic regression analyses were carried out to explore the risk of low birthweight (LBW), preterm births, small for gestational age (SGA) infants, preeclampsia and delivery mode (vaginal vs caesarean section (CS)) for the study and comparison groups, after adjusting for potential confounders.
Results Regression analyses showed that the adjusted odds of LBW, SGA infants, preeclampsia and CS for women with RA were 1.47 (95% CI 1.22 to 1.78), 1.20 (95% CI 1.05 to 1.38), 2.22 (95% CI 1.59 to 3.11) and 1.19 (95% CI 1.07 to 1.31) times, respectively, that of comparison mothers.
Conclusion After adjusting for potential confounding factors, women with RA had an increased risk of LBW, SGA babies, preeclampsia and CS compared with unaffected women. These findings suggest a need for active monitoring and early intervention to counter the increased risk of adverse obstetric outcomes for pregnant women with RA.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent Obtained.