FRI0306 WOMEN WITH AXIAL SPONDYLOARTHRITIS HAVE COMPARABLE RATES OF COMPLICATIONS IN PREGNANCY TO WOMEN IN THE GENERAL POPULATION BUT MORE CAESAREAN DELIVERIES: RESULTS FROM NATIONWIDE CLAIMS DATA
Authors: I. Redeker, A. Strangfeld, U. Marschall, A. Zink, X. Baraliakos
Journal: Annals of the Rheumatic Diseases (2020)

Background: In contrast to other rheumatic inflammatory diseases, studies on pregnancy outcomes in axial spondyloarthritis (axSpA) are scarce, despite its onset in early adulthood affecting women in their reproductive years. Objectives: To investigate maternal and infant pregnancy outcomes among women with axSpA compared with population-based controls. Methods: Taking advantage of a large health insurance dataset, comprising the period 2006 – 2018, maternal and infant pregnancy outcomes and delivery outcomes of women with axSpA were assessed and compared with population-based controls (matched by maternal age and calendar year of birth). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using generalised estimating equation analyses. Results: A total of 611 singleton births among 535 women with axSpA were included in the analysis. The mean age at delivery was 32.5 years. The pharmacological treatment within 12 months prior to and after conception is illustrated in the Figure. Infants of women with axSpA were only slightly more often preterm (5.2% vs 4.7%) and small-for-gestational-age (1.6% vs 1.1%) than infants of matched population-based controls, respectively. Caesarean section was performed in 36% of deliveries among women with axSpA compared with 29.5% in population-based controls, resulting in a significantly increased risk for receiving caesarean section (OR 1.35; 95% CI 1.06-1.73) (Table). The occurrence of pre-eclampsia, preterm birth, and small-for-gestational-age was moderately higher, but not significantly increased, among women with axSpA as compared to population-based controls. Conclusion: Women with axSpA had no significantly increased risks for adverse maternal or infant pregnancy outcomes compared to non-axSpA women. However, a significantly increased risk for receiving caesarean section and a tendency for a higher number of preterm deliveries and of small-for-gestational-age infants was observed in women with axSpA. Table. Prevalences and odds ratios with 95% confidence intervals for adverse pregnancy outcomes Pregnancies in women with axSpA N=611 Pregnancies in population-based controls N=611 Odds Ratio (95% CI) Preterm birth (&lt; week 37) 5.2% (32) 4.7% (29) 1.11 (0.66, 1.85) Gestational week 28-36 4.9% (30) 4.7% (29) 1.03 (0.61, 1.75) Gestational week &lt;28 0.3% (2) 0.2% (1) 2.01 (0.18, 22.18) Small for gestational age 1.6% (10) 1.1% (7) 1.43 (0.54, 3.79) Low birth weight (&lt;2500 g) 2.8% (17) 2.6% (16) 1.06 (0.53, 2.13) Exceptionally large baby (birth weight ≥4500 g) 1.1% (7) 0.2% (1) 7.07 (0.87, 57.63) Pre-eclampsia 7.5% (46) 6.4% (39) 1.21 (0.78, 1.90) Assisted vaginal delivery 4.3% (26) 3.1% (19) 1.39 (0.76, 2.56) Caesarean section 36.0% (220) 29.5% (180) 1.35 (1.06, 1.73) axSpA, axial Spondyloarthritis; CI, confidence interval. Acknowledgments: We would like to thank the BARMER Statutory Health Insurance for providing data for this study. Disclosure of Interests: Imke Redeker: None declared, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis, Ursula Marschall: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen