Remaeus K, et al. - The pregnancy outcomes in a large and contemporary cohort of women diagnosed with juvenile onset arthritis (JIA) are evaluated in this study. In the light of these outcomes, they found increased risks of both maternal and infant complications among women with JIA confined to childhood and in women with JIA persistent into adulthood as compared with population controls. Pregnancies in women with JIA should thus be subject to increased surveillance amid pregnancy and delivery.

Methods

• For this research, they designed a nationwide Swedish population-based cohort study.
• They identified 1807 births among women with JIA and 1949202 control births from 1992 and 2011.
• Since JIA is a heterogenic condition, births to women with JIA was divided into JIA paediatric only (n=1169) and JIA persisting into adulthood (n=638).
• ORs and 95% CIs were evaluated with generalised assessing equations.

Results

• Women with JIA were at increased risk of preterm birth, particularly medically demonstrated, in both subgroups: adjusted OR (aOR) 1.74 (1.35-2.67) for JIA paediatric and aOR 4.12 (2.76-6.15) for JIA persisting into adulthood.
• JIA persisting into adulthood was related to very preterm birth (aOR 3.14, 1.58-6.24), spontaneous preterm birth (aOR 1.63, 1.11-2.39), small for gestational age birth (aOR 1.84, 1.19-2.85), early-onset pre-eclampsia (aOR 6.28, 2.68-13.81) and late-onset pre-eclampsia (aOR 1.96, 1.31-2.91).
• Women with JIA paediatric only were at increased risk of delivery by caesarean section (aOR 1.42, 1.66-1.73) and induction of labour (aOR 1.45, 1.18-1.77).