Women with Rheumatoid Arthritis have similar rates of postpartum maternal outcomes compared to women without autoimmune disease.
Women with Rheumatoid Arthritis have similar rates of postpartum maternal outcomes compared to women without autoimmune disease.
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DOI：
10.1016/j.semarthrit.2022.151975
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发表时间：
2022-04
影响因子：
5
通讯作者：
Barnado A
中科院分区：
文献类型：
--
作者：
Tarplin S;Hubbard J;Green S;Whitney R;Wheless L;Barnado A
关于类风湿性关节炎(RA)对产妇产后结局的影响的数据有限。使用真实世界的电子健康记录(EHR)队列，我们评估了类风湿性关节炎产妇的产后结局。在一个大型的、未识别的电子病历中，我们使用ICD-9或≥-10-CM代码和经过验证的RA算法确定了可能的RA交付。类风湿性关节炎病例需要由风湿科医生在病历复习时进行诊断。产妇的产后结局包括输血率、临床医生定义的产后6周内的感染率和住院时间。我们还确定了对没有自身免疫性疾病的女性的接生。我们确定了202例发生在RA诊断后的分娩，以及596例没有自身免疫性疾病的对照组分娩。RA患者和对照组的产后感染率相似(8%比4%，p=0.10)，红细胞输血率也相似(2%比2%，p=1.00)。RA病例状态与产后感染无显著相关性(OR=2.10，95%CI0.88~4.98，p=0.0 9)，但与早产显著相关(OR=2.11，95%CI1.38~3.23，p=0.001)。妊娠期使用皮质类固醇的比例为41%，而使用肿瘤坏死因子抑制剂的比例为13%。在调整了分娩时的年龄和种族后，分娩时使用皮质类固醇与产后母体感染无关，但与RA病例中显著较低的出生体重有关。患有类风湿关节炎的妇女不良妊娠结局的风险增加，特别是早产。然而，我们的研究强调，RA患者的产妇产后结局，如产后感染和输血，并没有显著增加。
Limited data exists on the effect of rheumatoid arthritis (RA) on maternal postpartum outcomes. Using a real-world, electronic health record (EHR) cohort, we assessed maternal postpartum outcomes in RA. In a large, de-identified EHR, we identified possible RA deliveries using ≥1 delivery ICD-9 or ICD-10-CM codes and a validated RA algorithm. RA cases were required to be diagnosed by a rheumatologist on chart review. Maternal postpartum outcomes included rates of blood transfusion, rates of infection up to 6 weeks postpartum defined by a clinician, and length of hospital stay. We also identified deliveries to women without autoimmune diseases. We identified 202 deliveries occurring after RA diagnosis and 596 deliveries to controls without autoimmune diseases. Postpartum infection rates were similar among RA patients and controls (8% vs. 4%, p = 0.10), as were red blood cell transfusion rates (2% vs. 2%, p = 1.00). RA case status was not significantly associated with postpartum infection (OR = 2.10, 95% CI 0.88 – 4.98, p = 0.09) but was significantly associated with preterm birth (OR = 2.11, 95% CI 1.38 – 3.23, p = 0.001). Corticosteroid use during pregnancy was common at 41%, while tumor necrosis factor inhibitor use was 13%. After adjusting for age at delivery and race, corticosteroid use at delivery was not associated with postpartum maternal infections but was associated with a significantly lower birthweight in RA cases. Women with RA have an increased risk of adverse pregnancy outcomes, particularly preterm birth. Our study highlights, however, that maternal postpartum outcomes such as postpartum infection and blood transfusion are not significantly increased in RA patients.
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影响因子：
2.3
作者：
Barnabe C;Faris PD;Quan H
通讯作者：
Quan H
影响因子：
2.3
作者：
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通讯作者：
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DOI：
10.1136/bmj.f6564
发表时间：
2013-11-07
期刊：
BMJ (Clinical research ed.)
影响因子：
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作者：
Ananth CV;Keyes KM;Wapner RJ
通讯作者：
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DOI：
10.1080/14767058.2018.1498835
发表时间：
2020-01-01
影响因子：
1.8
作者：
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通讯作者：
Abenhaim, Haim A.
影响因子：
2.3
作者：
Boulet, Sheree L.;Okoroh, Ekwutosi M.;Hooper, W. Craig
通讯作者：
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