OP0211 PATERNAL INFLAMMATORY ARTHRITIS IS ASSOCIATED WITH A HIGHER RISK OF MISCARRIAGES: RESULTS OF A LARGE MULTICENTER STUDY (IFAME-FERTILITY)
Authors: L. F. Perez-Garcia, E. Röder, R. Goekoop, M. R. Kok, P. Kok, H. T. Smeele, I. Tchetverikov, A. Van der Helm - van Mil, J. H. Van der Kaap, B. Krijthe, R. Dolhain
Journal: Annals of the Rheumatic Diseases (2021)

Background: The effect of inflammatory arthritis (IA) on pregnancy outcomes has been studied mainly in women. Paternal older age, sperm DNA integrity and certain genetic defects have been associated with worse pregnancy outcomes (1). However, pregnancy outcomes of partners of men with IA have never been studied. Objectives: To describe the pregnancy characteristics and outcomes of partners of men diagnosed with IA. Methods: We performed a multicenter cross-sectional retrospective study conducted in eight Dutch hospitals. Men with IA (Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA) and Spondyloarthritis (SpA)) who were over 40 years old and indicated that their family size was complete were invited to participate. Participants completed a digital questionnaire that included pregnancy-related questions and questions regarding their demographic and clinical information. To analyze the impact of IA on pregnancy outcomes, pregnancies were classified into two groups; pregnancies that occurred after diagnosis of IA and before the diagnosis of IA. Results: In total 628 male participants diagnosed with IA were included. 408 men reported 897 singleton pregnancies that resulted in 794 live births. Regarding pregnancy characteristics, pregnancies conceived after diagnosis of IA had a higher mean paternal and maternal age at conception and a lower rate of spontaneous pregnancies (90.91 vs 96.60%, p=&lt;0.005) (See Table 1). With regards to pregnancy outcomes, pregnancies conceived after receiving the diagnosis of IA had a lower rate of live births (86.36% and 89.22%, p=0.053) and a significant higher rate of miscarriages (12.27 vs 7.53%, p=&lt;0.05). After correcting for maternal age and year of pregnancy, pregnancies conceived after the diagnosis of IA had a higher risk of miscarriages (OR 1.71 [CI 1.04-2.81], p&lt;0.05). No statistically significant differences between the two groups were reported for the rates of abortions, preterm births and pregnancy complications. Table 1. Pregnancy characteristics and outcomes. All pregnancies Pregnancy after diagnosis of IA Pregnancy before diagnosis of IA P value Pregnancy characteristics Total number of pregnancies 897 220 677 Maternal age at conception, mean (SD) 29.00 (5.00) 30.69 (5.16) 28.45 (4.83) p&lt;0.005 Paternal age at conception, mean (SD) 31.31 (5.72) 34.27 (6.08) 30.49 (5.34) p&lt;0.005 Spontaneous pregnancy, n (%) 854 (95.21) 200 (90.91) 654 (96.60) p&lt;0.005 Pregnancy duration-months, median (IQR) 39 (38-40) 39 (38-40) 39 (38-40) p=0.928 Pregnancy outcomes Live births, n (%) 794 (88.52) 190 (86.36) 604 (89.22) p=0.053 Miscarriage, n (%) 78 (8.70) 27 (12.27) 51 (7.53) p&lt;0.05 Abortion, n (%) 25 (2.78) 3 (1.36) 22 (3.25) p=0.128 *Medical indication 5 (20.00) 0 (0) 5 (22.73) *Personal reasons 20 (80.00) 3 (100.00) 17 (77.27) Pre-term birth 149 (16.61) 31 (14.09) 118 (17.43) p=0.248 Pregnancy complications No complications during pregnancy, n (%) 754 (84.34) 184 (83.64) 570 (84.57) p=0.741 Hypertensive disorders (hypertension, pre/eclampsia), n (%) 41 (4.57) 8 (3.64) 33 (4.87) p=0.445 Gestational Diabetes Mellitus 11 (1.28) 2 (0.94) 9 (1.38) p=0.619 Growth restriction 12 (1.34) 1 (0.45) 11 (1.65) p=0.193 Conclusion: This is the largest study to describe the pregnancy characteristics and outcomes of partners of men diagnosed with IA and the first to demonstrate that paternal IA is associated with a higher risk of miscarriage. Prospective studies are needed to corroborate these findings. References: [1]Ibrahim Y, Johnstone E. The male contribution to recurrent pregnancy loss. Translational andrology and urology. 2018;7(Suppl 3):S317-S27. Acknowledgements: The authors would like to acknowledge Ron Buijs, data manager of the Department of Rheumatology of the Erasmus MC, for his technical support with regards to data collection. Disclosure of Interests: Luis Fernando Perez-Garcia Consultant of: Galapagos, Esther Röder: None declared, Robbert Goekoop: None declared, Marc R Kok Consultant of: Roche, Grant/research support from: Roche, Petra Kok: None declared, Hieronymus TW Smeele: None declared, Ilja Tchetverikov: None declared, Annette van der Helm - van Mil: None declared, J.H. van der Kaap: None declared, Bouwe Krijthe: None declared, Radboud Dolhain Speakers bureau: Abbvie, UCB, Genzyme, Novartis, Consultant of: Galapagos, Grant/research support from: UCB