Background There is sparse documentation on pregnancy outcomes in women with spondyloarthritis (SpA) and psoriatic arthritis (PsA). Data on disease activity is often lacking, preventing the direct investigation of the effect of inflammation on pregnancy outcomes. A cesarean section (CS) implies a higher risk for the mother than vaginal delivery. It delays mobilization after birth necessary to counteract inflammatory pain and stiffness as well as the (re)start of disease modifying medication.
Objectives To explore the possible association of disease activity (inflammation) and occurrence of cesarean section in women with SpA and PsA.
Methods Data from the Medical Birth Registry of Norway (MBRN) were linked with data from RevNatus, a nationwide observational register recruiting women with inflammatory rheumatic diseases. Singleton births in women with SpA and PsA included in RevNatus 2010 to 2019 were cases. All other singleton births registered in MBRN during this time served as population controls.
Results CS occurred more frequently in both SpA (21.9%) and PsA (29.4%) compared to population controls (15.6%), with even higher frequencies in active SpA (23.5%) and active PsA (30.1%). Women with SpA had higher risk for elective CS (risk difference 4.1%, 95% CI 1.4% to 7.9%, p=0.002), while women with PsA had higher risk for emergency CS (risk difference 9.8%, 95% CI 3.8% to 17.6%, p<0.001) as compared to population controls.
Conclusion Women with SpA and PsA had increased odds for elective and emergency CS, respectively. Further analysis will explore the role of active inflammation.
References Mørk, S et al. Spondyloarthritis and Outcomes in Pregnancy and Labor: A Nationwide Register-Based Cohort Study. Arthritis Care Res (Hoboken). 2021 Feb;73(2):282-288
Disclosure of Interests None declared
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