Sofie Mørk1, Anne Voss2, Sören Möller3, Mette Bliddal3. 1. Department of Obstetrics and Gynecology, Labor Ward, Odense University Hospital, Baagøes Alle 15, 5700, Svendborg, Denmark. 2. Odense University Hospital, Department of Rheumatology, Odense, Denmark. 3. Odense University Hospital, Odense Patient data Explorative Network (OPEN), Odense, Denmark.
Abstract
OBJECTIVE: To describe the prevalence of Spondyloarthritis (SpA) and subtypes diagnosed prior to delivery in a nationwide pregnant population and to estimate how SpA was associated with adverse pregnancy-related outcomes. METHODS: Using the Danish Medical Birth Register, we identified 1,199,610 singleton pregnancies (1997-2016). Information on SpA and related subtypes (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel diseases, and undifferentiated SpA) were derived from the Danish National Patient Registry. Odds ratios were calculated using logistic regression models. The analyses were performed with overall SpA as exposure and stratified by subtype. RESULTS: The overall prevalence of SpA diagnosed prior to labor was 0.31%, increasing from 0.1% in 1997 to 0.6% in 2016. Comparing women without SpA to women with SpA, the adjusted odds ratios were increased for moderately preterm birth (OR 1.56 [95% CI: 1.33-1.83]), very preterm birth (OR 1.47 [95% CI: 1.04-2.08]), elective cesarean sectio (OR: 1.44 [95% CI: 1.26-1.64]), emergency cesarean section OR 1.17 [95% CI: 1.04-1.33]), and use of epidural (OR 1.11 [95% CI: 1.02-1.20]). The odds ratios for small for gestational age birth and preeclampsia were not increased for SpA women compared to controls. Results were comparable for the subtypes of SpA. CONCLUSION: Pregnancies in women with SpA were more often complicated by adverse pregnancy outcomes than pregnancies in women without SpA. Clinicians should be aware of this when consulting women with SpA in their childbearing years. Future research should focus on investigating causal relations and possible interventions aimed at preventing these outcomes.
OBJECTIVE: To describe the prevalence of Spondyloarthritis (SpA) and subtypes diagnosed prior to delivery in a nationwide pregnant population and to estimate how SpA was associated with adverse pregnancy-related outcomes. METHODS: Using the Danish Medical Birth Register, we identified 1,199,610 singleton pregnancies (1997-2016). Information on SpA and related subtypes (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel diseases, and undifferentiated SpA) were derived from the Danish National Patient Registry. Odds ratios were calculated using logistic regression models. The analyses were performed with overall SpA as exposure and stratified by subtype. RESULTS: The overall prevalence of SpA diagnosed prior to labor was 0.31%, increasing from 0.1% in 1997 to 0.6% in 2016. Comparing women without SpA to women with SpA, the adjusted odds ratios were increased for moderately preterm birth (OR 1.56 [95% CI: 1.33-1.83]), very preterm birth (OR 1.47 [95% CI: 1.04-2.08]), elective cesarean sectio (OR: 1.44 [95% CI: 1.26-1.64]), emergency cesarean section OR 1.17 [95% CI: 1.04-1.33]), and use of epidural (OR 1.11 [95% CI: 1.02-1.20]). The odds ratios for small for gestational age birth and preeclampsia were not increased for SpA women compared to controls. Results were comparable for the subtypes of SpA. CONCLUSION: Pregnancies in women with SpA were more often complicated by adverse pregnancy outcomes than pregnancies in women without SpA. Clinicians should be aware of this when consulting women with SpA in their childbearing years. Future research should focus on investigating causal relations and possible interventions aimed at preventing these outcomes.