Pregnancy outcomes in women with juvenile idiopathic arthritis: a population-based study
Pregnancy outcomes in women with juvenile idiopathic arthritis: a population-based study
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DOI：
10.1093/rheumatology/kes428
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发表时间：
2013-06-01
期刊：
影响因子：
5.5
通讯作者：
March, Lyn M.
中科院分区：
文献类型：
--
作者：
Chen, Jian Sheng;Ford, Jane B.;March, Lyn M.
Objective.本研究的目的是描述JIA妇女的妊娠结局。在澳大利亚新南威尔士州（NSW）分娩的妇女与2000年至2010年的出院记录有关。在医院记录中ICD-10-AM代码为M08或M09的妇女被认为患有JIA。Logistic回归分析用于计算妊娠结局的比值比，并使用广义估计方程考虑同一妇女多胎妊娠研究结局缺乏独立性。在研究期间，601 659名妇女生育了941 496个孩子。在这些分娩中，78例分娩可归因于50名患有JIA的妇女。在78例JIA妊娠中，53例（68%）通过剖腹产（n = 40，51%）或器械分娩（n = 13，17%）分娩;与其他女性相比，JIA患者的先兆子痫、产后出血和严重孕产妇发病率显著较高。与其他婴儿相比，母亲患有JIA的婴儿更有可能早产，但未增加小于胎龄儿、需要新生儿重症监护、5 min Apgar评分低或新生儿严重发病的风险。患有JIA的妇女的婴儿并没有增加新生儿不良结局的风险。由于产妇发病风险增加，JIA妇女在怀孕期间可能需要加强产科护理。
Objective. The aim of this study is to describe pregnancy outcomes among women with JIA.Methods. Women who gave birth in New South Wales (NSW), Australia, were linked to hospital discharge records from 2000 to 2010. Women with an ICD-10-AM code of M08 or M09 in the hospital records were considered to have JIA. Logistic regression was used to calculate odds ratios for pregnancy outcomes and the lack of independence in study outcomes for multiple pregnancies in the same woman was taken into account using generalized estimating equations.Results. During the study period, 601 659 women had 941 496 births. Of these births, 78 births could be attributed to 50 women with JIA. Of 78 JIA pregnancies, 53 (68%) were delivered by either Caesarean section (n = 40, 51%) or instrumental delivery (n = 13, 17%); compared with other women, those with JIA had significantly higher rates of pre-eclampsia, postpartum haemorrhage and severe maternal morbidity. Compared with other infants, those with mothers with JIA were more likely to be born prematurely, but were not at increased risk of being small for gestational age, requiring neonatal intensive care, having a low Apgar score at 5 min or severe neonatal morbidity.Conclusion. Infants of women with JIA did not have an increased risk of adverse neonatal outcomes. Intensive obstetric care might be required during pregnancy for women with JIA given the increased risk of maternal morbidity.