OP0135 Foetal-neonatal and maternal outcomes in women with rheumatoid arthritis
Authors: Y.-C. Tsai, S.-F. Luo, M.-J. Chiou, C.-F. Kuo
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Pregnancy involves adaptation to the immune system to prevent rejection of the foetus and this might have consequences on the activity of the rheumatoid arthritis (RA). Equally the aberrant immunity and disease activity of the RA might influence the pregnancy and foetal-neonatal outcomes. <h3>Objectives</h3> This study was designed to estimate the risk of adverse foetal-neonatal and maternal outcomes in pregnancies in women with RA. <h3>Methods</h3> We identified 2,350,339 singleton pregnancies using the Taiwan National Health Insurance database and birth registry between 2001 and 2012. Maternal history of RA, SLE, Sjögren's syndrome, systemic sclerosis, vasculitis and poly/dermatomyositis were ascertained; among them, 845 individuals had RA. Odds ratios (ORs) and 95% confidence intervals (CIs) for pregnancy outcomes were estimated using an adjusted generalised estimating equation model. <h3>Results</h3> Pregnancies in women with RA were associated with an OR (95% CI) of 1.65 (1.37–1.98) for low birthweight (&lt;2500 g) (n=114), 1.41 (1.128–1.68) for prematurity (&lt;37 week) (n=124), and 1.62 (1.36–1.92) for small for gestational age (n=132). Maternal outcomes in pregnancies of women with RA were just associated with an OR (95% CI) of 1.34 (1.06–1.68) for preterm labour (n=74). Women with RA did not have an increased risk of post-partum death, cardiovascular complications, surgical complications, and the other systemic organ dysfunction. <h3>Conclusions</h3> Pregnancies in women with RA were at a higher risk for multiple adverse foetal-neonatal outcomes, especially low birthweight (&lt;2500 g), prematurity (&lt;37 week), and small for gestational age. Maternal outcomes showed that just preterm labour was more common in women with RA. Women with RA should not be discouraged to seek pregnancy based on the disease alone. <h3>References</h3> [1] Michet CJ Jr, McKenna CH, Elveback LR, Kaslow RA, Kurland LT. Epidemiology of systemic lupus erythematosus and other connective tissue diseases in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc1985;60(2):105–113. [2] Chiu YM, Lai CH. Nationwide population-based epidemiologic study of systemic lupus erythematosus in Taiwan. Lupus2010;19(10):1250–1255. [3] Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W. The incidence and prevalence of systemic lupus erythematosus in the UK, 1999–2012. Ann Rheum Dis2016;75(1):136–141. [4] See LC, Kuo CF, Chou IJ, Chiou MJ, Yu KH. Sex- and age-specific incidence of autoimmune rheumatic diseases in the Chinese population: A Taiwan population-based study. Semin Arthritis Rheum2013;43(3):381–386. [5] Cutolo M, Matucci-Cerinic M, Lockshin M, Ostensen M. Introduction: New trends in pregnancy and rheumatic diseases. Rheumatology (Oxford)2008;47(Suppl 3):iii1. <h3>Acknowledgements</h3> The authors would like to thank Centre for Big Data Analytics and Statistics in Chang Gung Memorial Hospital for statistical consultation. The sponsors of the study had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. <h3>Disclosure of Interest</h3> None declared