Kristin Ursin1,2, Stian Lydersen3,4, Johan F Skomsvoll3,4, Marianne Wallenius3,4. 1. From the National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital; Department of Neuromedicine and Movement Science, Faculty of Medicine, Norwegian University of Science and Technology (NTNU); Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU, Trondheim, Norway. kristin.ursin@ntnu.no. 2. K. Ursin, MD, National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, and Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU; S. Lydersen, PhD, Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU; J.F. Skomsvoll, MD, PhD, National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital; M. Wallenius, MD, PhD, National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, and Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU. kristin.ursin@ntnu.no. 3. From the National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital; Department of Neuromedicine and Movement Science, Faculty of Medicine, Norwegian University of Science and Technology (NTNU); Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU, Trondheim, Norway. 4. K. Ursin, MD, National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, and Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU; S. Lydersen, PhD, Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU; J.F. Skomsvoll, MD, PhD, National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital; M. Wallenius, MD, PhD, National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, and Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU.
Abstract
OBJECTIVE: To study disease activity in women with juvenile idiopathic arthritis (JIA) during and after pregnancy. There is little previous knowledge about this topic. METHODS: Our study included 135 pregnancies in 114 women with JIA. Disease activity was assessed at 7 timepoints before, throughout, and after pregnancy with the Disease Activity Score-28-C-reactive protein 3 (DAS28-CRP3). Scores assessed at each visit were analyzed in a linear mixed model. The same statistical method was used to study self-reported physical function, pain, and mental health. RESULTS: Almost 80% of the women were in remission or had low disease activity during and after pregnancy. Although disease activity was stable throughout the study period, we found that DAS28 6 weeks postpartum increased significantly compared to the first trimester (2.78 vs 2.51, p = 0.005) and third trimester (2.78 vs 2.56, p = 0.011), respectively. DAS28 decreased significantly between 6 weeks and 12 months postpartum (2.78 vs 2.54, p = 0.014). Self-reported mental health was significantly better 6 weeks postpartum than before pregnancy (Medical Outcomes Study Short Form-36 Mental Health subscale 80.7 vs 76.5, p = 0.039). Self-reported pain was stable. Physical function was significantly worse in the third trimester of pregnancy than postpartum (Modified Health Assessment Questionnaire 0.57 vs 0.39, p < 0.001). CONCLUSION: In women with JIA, disease activity was highest 6 weeks postpartum, but altogether low and stable in the period from planning pregnancy to 1 year after delivery.
OBJECTIVE: To study disease activity in women with juvenile idiopathic arthritis (JIA) during and after pregnancy. There is little previous knowledge about this topic. METHODS: Our study included 135 pregnancies in 114 women with JIA. Disease activity was assessed at 7 timepoints before, throughout, and after pregnancy with the Disease Activity Score-28-C-reactive protein 3 (DAS28-CRP3). Scores assessed at each visit were analyzed in a linear mixed model. The same statistical method was used to study self-reported physical function, pain, and mental health. RESULTS: Almost 80% of the women were in remission or had low disease activity during and after pregnancy. Although disease activity was stable throughout the study period, we found that DAS28 6 weeks postpartum increased significantly compared to the first trimester (2.78 vs 2.51, p = 0.005) and third trimester (2.78 vs 2.56, p = 0.011), respectively. DAS28 decreased significantly between 6 weeks and 12 months postpartum (2.78 vs 2.54, p = 0.014). Self-reported mental health was significantly better 6 weeks postpartum than before pregnancy (Medical Outcomes Study Short Form-36 Mental Health subscale 80.7 vs 76.5, p = 0.039). Self-reported pain was stable. Physical function was significantly worse in the third trimester of pregnancy than postpartum (Modified Health Assessment Questionnaire 0.57 vs 0.39, p < 0.001). CONCLUSION: In women with JIA, disease activity was highest 6 weeks postpartum, but altogether low and stable in the period from planning pregnancy to 1 year after delivery.
Authors: Giuseppe Marrone; Francesco Galati; Marco Biolato; Cristopher Oddy; Sara De Carolis; Angelo Zoli; Antonio Grieco Journal: BMC Gastroenterol Date: 2021-08-06 Impact factor: 3.067