van den Brandt S, et al. - In subjects having RA and axial spondyloarthritis (axSpA), researchers evaluated the pregnancy outcome and delivery mode in relation to disease activity and anti-rheumatic drugs. They noted that pregnancy outcomes were influenced by the disease activity of RA and axSpA during pregnancy. A treatment strategy that targets inactive disease beyond conception ought to be followed in order to allow for successful pregnancy.

Methods

• Researchers compared the subjects with RA and axSpA to the age-matched healthy controls (HCs) with respect to pregnancy outcome and delivery mode.
• Once at each trimester they assessed the disease activity (DAS28, ASDAS, CRP) and medication use of subjects.
• With univariate and multivariate regression models, ORs with 95% CI were calculated.

Results

• Researchers assessed 244 pregnancies, out of which 96 occurred in subjects with RA, 78 in subjects with axSpA and 70 in HCs.
• Findings suggested a higher risk of pregnancy complications (gestational diabetes, preeclampsia, infection, preterm premature rupture of membranes), small for gestational age infants and preterm deliveries (all P < 0.05) in pregnant women with RA and axSpA.
• In both RA [odds ratio (OR) = 3.9, 95% CI: 1.25, 12.15] and axSpA (OR = 13.8, 95% CI: 1.33, 143.94), active disease was a predictor for preterm delivery.
• As per the findings, most subjects had vaginal deliveries.
• Nonetheless, compared to HC (P < 0.05), women with RA revealed an increased risk of caesarean section, which was not seen in subjects with axSpA.