Pregnant rheumatoid arthritis (RA) patients may benefit from more intensive antenatal care, suggest researchers on finding such women to have an increased risk for low birthweight and other adverse infant outcomes.
“Our findings suggest a need for active monitoring and early intervention to counter the increased risk for adverse obstetric outcomes for pregnant women with RA,” write Herng-Ching Lin (Taipei Medical University, Taiwan) and co-workers.
Following contradictory findings on the impact of RA on pregnancy and birth outcomes, the team examined data from the Taiwan National Health Insurance Research Dataset for women who had a live singleton birth between 2001 and 2003.
After excluding women with chronic diseases that impact on pregnancy outcome, the team matched 1912 mothers with RA with 9560 mothers without RA by age group, parity, and year of delivery.
As reported in the Annals of Rheumatic Disease, after adjusting for confounding factors, women with RA were more likely than controls to have infants with a low birthweight (<2500 g, odds ratio [OR]=1.47), or who were small for gestational age (birth weight below the 10th percentile, OR=1.20).
In addition, mothers with RA were more likely than controls to develop pre-eclampsia (OR=2.22), and to have undergone cesarean section (OR=1.19).
However, there was no link between RA and likelihood of pre-term birth, whether defined as before 37, 32, or 28 weeks’ gestation.
“Future studies are needed to examine the potential mechanisms by which RA produces adverse pregnancy outcomes,” conclude Lin et al.
They add: “Future studies exploring the association between adverse birth outcomes and severity of RA, and medications taken during pregnancy are also warranted, to enable more specific interpretation of these findings.”