Birth Outcomes and Rehospitalizations Among Pregnant Women With Rheumatoid Arthritis and Systemic Lupus Erythematosus and Their Offspring.
Birth Outcomes and Rehospitalizations Among Pregnant Women With Rheumatoid Arthritis and Systemic Lupus Erythematosus and Their Offspring.
复制标题
患有类风湿关节炎和系统性红斑狼疮的孕妇及其后代的出生结果和再住院情况。
DOI：
10.1002/acr.25087
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发表时间：
2023
影响因子：
4.7
通讯作者：
Mueller,BethA
中科院分区：
文献类型：
--
作者：
Singh,Namrata;Sabo,Julianna;Crane,DeborahA;Doody,DavidR;Schiff,MelissaA;Mueller,BethA
目的比较患有和不患有类风湿性关节炎(RA)或系统性红斑狼疮(SLE)的妇女及其婴儿的产科/出生结局和再住院情况。方法这项基于人群的回顾性队列研究确定了华盛顿州1987-2014年出生的单胎妇女(n=1,354)和患有RA(n=1,223)和SLE(n=1,354)的非暴露妇女。通过估计调整后的相对风险(RR)和原因特定的再住院风险比(HR)，以95%的可信区间(95%CI)比较结果，包括原因特定住院和产后2年。结果我们观察到几种不良结果的风险增加； 的调整相对风险通常最大。患有类风湿性关节炎/系统性红斑狼疮的女性更需要再次住院，最明显的是在产后6个月(类风湿性关节炎：4%对2%；相对危险度2.22[95%可信区间1.62-3.04]；系统性红斑狼疮：6%对2%；相对危险度2.78[95%可信区间2.15-3.59])。肌肉骨骼疾病的产妇产后再住院率最高(RA：HR 19.1[95%CI 13.6-26.8]；SLE：HR 29.8[95%CI 22.1-40.1])。系统性红斑狼疮患者的婴儿更容易出现畸形(9%比6%；相对危险度1.46[95%可信区间1.21-1.75])，并且在两个 年时死亡率增加(相对危险度2.11[95%可信区间1.21-3.67])。患有系统性红斑狼疮的妇女的婴儿在出生后第一年也经历了更频繁的再住院。结论患有类风湿关节炎或系统性红斑狼疮的妇女及其婴儿有不良结局，特别是患有系统性红斑狼疮的妇女的婴儿。产妇/婴儿再住院更常见；最明显的是产后早期。在这些时间段内密切跟踪是将不良后果降至最低的关键。
ObjectiveTo compare obstetric/birth outcomes and rehospitalization among women with and without rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and their infants.MethodsThis population‐based retrospective cohort study identified women with RA (n = 1,223) and SLE (n = 1,354) and unexposed women with singleton births 1987–2014 in Washington State in linked vital hospital discharge records. Outcomes, including cause‐specific hospitalizations <2 years postpartum, were compared by estimating adjusted relative risks (RRs) and cause‐specific rehospitalization hazard ratios (HRs) with 95% confidence intervals (95% CIs).ResultsWe observed increased risks of several adverse outcomes; RRs were often greatest for SLE. Women with RA/SLE more often required rehospitalization, most notably at <6 months postpartum (RA: 4% versus 2%; RR 2.22 [95% CI 1.62–3.04]; SLE: 6% versus 2%; RR 2.78 [95% CI 2.15–3.59]). Maternal postpartum rehospitalization was greatest for musculoskeletal conditions (RA: HR 19.1 [95% CI 13.6–26.8]; SLE: HR 29.8 [95% CI 22.1–40.1]). Infants of women with SLE more often had malformations (9% versus 6%; RR 1.46 [95% CI 1.21–1.75]), and increased mortality at <2 years (RR 2.11 [95% CI 1.21–3.67]). Infants of women with SLE also experienced more frequent rehospitalizations in their first year of life.ConclusionWomen with RA or SLE and their infants experienced adverse outcomes, particularly infants of women with SLE. Maternal/infant rehospitalization was more common; most marked in the early months postpartum. Close follow‐up during these time periods is crucial to minimize adverse outcomes.