Pregnancy outcomes in women with rheumatoid arthritis: a retrospective population-based cohort study
Pregnancy outcomes in women with rheumatoid arthritis: a retrospective population-based cohort study
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DOI：
10.1080/14767058.2018.1498835
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发表时间：
2020-01-01
影响因子：
1.8
通讯作者：
Abenhaim, Haim A.
中科院分区：
文献类型：
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作者：
Aljary, Hissah;Czuzoj-Shulman, Nicholas;Abenhaim, Haim A.
目的：评估类风湿关节炎（RA）孕妇发生不良孕产妇和新生儿结局的风险是否较高。材料和方法：采用美国医疗成本和利用项目-国家住院患者样本（HCUP-NIS）进行回顾性队列研究。根据ICD-9编码，确定了2004年至2013年发生的所有分娩，并将妇女分类为患有RA或不患有RA。采用无条件logistic回归评价RA对孕产妇和新生儿结局的调整效应。结果：在我们队列的8,417,607例分娩中，6068例为RA患者，总体患病率为每100,000例分娩72例。在10年的研究期间，怀孕期间风湿性关节炎的发病率稳步上升，从每10万人47例上升到100例。与没有类风湿关节炎的女性相比，患有类风湿关节炎的女性更容易发生先兆子痫/子痫、妊娠糖尿病、出现早产胎膜早破（PPROM）、胎盘早剥和前置胎盘，以及剖腹产。产后，ra并发症妊娠与伤口并发症和血栓栓塞有关。先天性异常、胎龄小和早产在RA女性新生儿中更为常见。结论：妊娠期RA与孕产妇和新生儿不良结局的可能性较大相关。患有类风湿性关节炎的妇女应该意识到这些风险，并被视为高危妊娠。
Purpose: To assess if pregnancies in women with rheumatoid arthritis (RA) are at a higher risk for adverse maternal and neonatal outcomes.Materials and methods: A retrospective cohort study was carried out using the Healthcare Cost and Utilization Project - National Inpatient Sample (HCUP-NIS) from the USA. All births that took place from 2004 to 2013 were identified and women were classified as having RA or not on the basis of ICD-9 coding. Unconditional logistic regression was used to evaluate the adjusted effect of RA on maternal and neonatal outcomes.Results: Of the total 8,417,607 births in our cohort, 6068 were among women with RA for an overall prevalence of 72 per 100,000 births. There was a steady increase in reported RA in pregnancy from 47 to 100 per 100,000 over the 10-year study period. Compared with women without RA, women with RA were more likely to develop pre-eclampsia/eclampsia, gestational diabetes, to present with preterm premature rupture of membranes(PPROM), to experience placental abruption and placenta previa, and to deliver by caesarean section. Postpartum, RA-complicated pregnancies were associated with wound complications and thromboembolisms. Congenital anomalies, small for gestational age and preterm birth were more common in neo-nates of women with RA.Conclusion: RA in pregnancy is associated with a greater likelihood of adverse maternal and neonatal outcomes. Women with RA should be made aware of these risks and be followed as a high risk pregnancy.