High RA disease activity linked to preterm delivery, low birth weight

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Bharti B, et al. J Rheumatol. 2015;doi:10.3899/jrheum.140583.

April 20, 2015
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Pregnant women with high disease activity in early pregnancy were more likely to have a preterm delivery or a child who was small for gestational age, according to newly published study findings.

Patients were identified through the Organization of Teratology Information Specialists (OTIS), a North American university and hospital-based network of telephone-based teratogen counseling services across the United States and Canada, and its Autoimmune Diseases in Pregnancy Project, a prospective cohort study of pregnant women both with and without an autoimmune disease. Researchers included 440 pregnant women with rheumatoid arthritis (RA) who were interviewed prior to 20 weeks gestation and at 2 weeks to 4 weeks after delivery.
, which included the HAQ Disability Index (HAQ-DI), pain score (PS) and Patient’s Global Scale (PGS) to assess disease activity. Data were self-reported and verified through medical records at the rate of up to 95% reviewed.

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RA and Pregnancy. What are the risks?

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From: The Rheumatologist, April 2015

Rheumatoid Arthritis and Pregnancy
by Richard Quinn

New research from a team in Denmark shows patients of reproductive age with rheumatoid arthritis (RA) require special attention—beyond the routine check for medication contraindications—during the prenatal process.

The first-of-its-kind research, published online in December in Arthritis & Rheumatology, looked at nearly 2 million children born in Denmark between 1977 and 2008, and found more than 13,000 children exposed to either maternal RA or maternal preclinical RA.1 Children exposed to maternal RA (n=2,101) were at approximately 50% higher risk of preterm birth; those exposed to maternal preclinical RA were at approximately 30% increased risk of preterm birth. Researchers found no association with paternal RA, and found only small differences in fetal biometry.

“Preterm birth is a well-known risk factor for a variety of adverse health outcomes in children, both short and long term,” says lead author Ane Rom, MPH, a reproductive epidemiologist in the Women’s and Children’s Health research unit at Copenhagen University Hospital. “Whether these children are at increased risk of adverse health outcomes later in life due to reduced fetal growth, we do not know.

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