Adverse Pregnancy Outcomes and Rheumatoid Arthritis: a Retrospective Matched Cohort Study

Background and Objective: Rheumatoid Arthritis (RA) is an autoimmune-driven chronic systemic inflammatory disease. It could result in miscarriage, pre-eclampsia, and preterm labor, among other unfavorable pregnancy outcomes. Thus, this study was conducted to investigate the adverse pregnancy outcomes in pregnant women with RA. Materials and Methods: Two cohorts of pregnant women with and without RA referred to the Ayatollah Mousavi Hospital's Gynecology and Obstetrics Clinic in Zanjan, Iran, during ۲۰۱۹-۲۰۲۰ were enrolled in a retrospective matched cohort study. Using their medical records, each participant completed a checklist of study variables. We used binary Logistic regression, chi-square test, Analysis of Variance, and independent samples t-test to analyze data using SPSS v.۲۳. Results: The study included ۲۸۰ pregnant women. The mean age of the RA and control group (pregnant women without RA) was ۳۲.۴ ± ۶.۶ and ۲۹.۵ ± ۶.۷ years, respectively. The most prevalent adverse outcome was spontaneous abortion (۵۴, ۱۹.۲۸%), which was significantly higher in the RA group (۲۵% vs. ۱۳.۶%, P= ۰.۰۱۵). Cesarean section (۲۴.۳% vs. ۱۰.۷%, P= ۰.۰۰۳) and low birth weight (LBW) were both significantly higher in the RA group (۱۵% vs. ۵%, P= ۰.۰۰۵). RA increased the probability of spontaneous abortion, cesarean section, and LBW by more than ۱.۳ (odds ratio, ۱.۳۸; ۹۵% CI, ۰.۴۵-۵.۴۶; P= ۰.۰۱۷), ۲.۲ (odds ratio, ۲.۲۴; ۹۵% CI, ۱.۲۹-۶.۵۴; P =۰.۰۰۴), and ۲.۶ (odds ratio, ۲.۶۷; ۹۵% CI, ۱.۸۶-۷.۰۵; P= ۰.۰۰۸) times, respectively. Conclusion: Pregnant women with RA are more likely to experience spontaneous abortion, cesarean section, and having LBW infants comparing to pregnant women without RA.

Keywords:

Rheumatoid Arthritis , Pregnancy , Cesarean Section , Spontaneous Abortion , Low Birth Weight