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17 Apr 2019
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Maternal RA tied to increased risk of multiple adverse outcomes

Elaine Soliven
28 Jun 2018
Pregnant women with rheumatoid arthritis (RA) are more likely to have premature delivery or baby of low birth weight compared with women without RA, according to a study presented at EULAR 2018.

Using data from the Taiwan National Health Insurance database and birth registry from 2001–2012, the researchers identified 2,350,339 singleton pregnancies, of whom 845 women had a history of RA. Maternal history of systemic lupus erythematosus, Sjögren’s syndrome, systemic sclerosis, vasculitis, and poly/dermatomyositis were also determined. [EULAR 2018, abstract OP0135]

Results showed that infants born to mothers with RA were more likely to have low birthweight (<2,500 g; odds ratio [OR], 1.65, 95 percent confidence interval [CI], 1.37–1.98; p<0.05), be born prematurely (<37 weeks; OR, 1.41, 95 percent CI, 1.18–1.68; p<0.05), and small-for-gestational-age (OR, 1.62, 95 percent CI, 1.36–1.92; p<0.05) compared with infants with non-RA mothers.

In addition, a higher risk of preterm labour (OR, 1.34, 95 percent CI, 1.06–1.68) was observed in women who had an RA during pregnancy, but there was no increased risk of cardiovascular complications, surgical complications, postpartum mortality, and other systemic organ dysfunction.

The findings are consistent with previous studies which revealed that maternal RA was associated with increased risks of several adverse pregnancy outcomes, such as low-birth-weight infants, premature delivery, intrauterine growth restriction, caesarean delivery, and pre-eclampsia. [Matern Child Health J 2006;10:361-366; J Intern Med 2010;268:329-337; Ann Rheum Dis 2010;69:715-717]

“Our results add to a growing body of evidence from different populations suggesting small but significant increases in prematurity and a decrease in birth weight in pregnancies in mothers with RA,” according to lead author Dr Tsai Yun-Chen from the Division of Rheumatology, Allergy, and Immunology at Chang Gung Memorial Hospital, Taoyuan, Taiwan.

“Pregnancy in patients with RA is very complex as there are many factors clinicians and patients need to consider,” said Professor Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR, who suggested that “more information is needed to understand implications of the disease and treatments on both mother and foetus.”

“[Nevertheless,] women with RA should not be discouraged to seek pregnancy based on the disease alone,” Tsai noted.
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Most Read Articles
17 Apr 2019
A family history of testicular cancer (TC), carcinoma, mesothelioma, sarcoma, malignant melanoma and malignant neuroepithelial tumours appears to increase the risk of paediatric and young adults’ TC, suggests a recent study.
19 Jul 2016
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Joyce Lam Ching Mei, 28 Mar 2019
April 17 marks World Haemophilia Day, and this year’s theme is  “Reaching Out – The First Step to Care”. Adjunct Assoc Prof Joyce Lam Ching Mei, head of the Haematology Laboratory and Blood Bank and senior consultant from the Paediatric Haematology/Oncology Service at KK Women’s and Children’s Hospital, Singapore, speaks to Elaine Soliven on the importance of recognizing and managing bleeding disorders in primary care.
Stephen Padilla, 28 Feb 2018
The 2-year preventive oral health programme in Singapore has succeeded in lowering the presence of severe early childhood caries (SECC) among infants and toddlers, driven primarily by the implementation of targeted behaviour modifications, such as reducing the consumption of sweetened milk and increased use of fluoridated toothpaste, reports a study.