High rate of preterm birth in pregnancies complicated by rheumatoid arthritis.
OBJECTIVE
To describe the outcomes of pregnancies complicated by rheumatoid arthritis (RA) and to estimate potential associations between disease characteristics and pregnancy outcomes.


METHODS
We reviewed all pregnancies complicated by RA delivered at our institution from June 2001 through June 2009. Fisher exact tests were used to calculate odds ratios. Univariable regression was performed using STATA 10.1 (StataCorp, College Station, TX). A p value of ≤ 0.05 was considered statistically significant.


RESULTS
Forty-six pregnancies in 40 women were reviewed. Sixty percent of pregnancies had evidence of disease flare and 28% delivered prior to 37 weeks. We did not identify associations between preterm birth and active disease at conception or during pregnancy. In univariate analysis, discontinuation of medication because of pregnancy was associated with a significantly earlier gestational age at delivery (362/7 versus 383/7 weeks, p = 0.022).


CONCLUSIONS
Women with RA may be at higher risk for preterm delivery.
Department of Obstetrics and Gynecology, Stanford University, Stanford, California.
Elizabeth S
ES
Langen
Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma.
Eliza F
EF
Chakravarty
Medical School, University of Utah, Salt Lake City, Utah.
Maryam
M
Liaquat
Department of Obstetrics and Gynecology, Stanford University, Stanford, California.
Yasser Y
YY
El-Sayed
Department of Obstetrics and Gynecology, Stanford University, Stanford, California.
Maurice L
ML
Druzin
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000453:epidemiology*; D000013:Congenital Abnormalities / Q000453:epidemiology; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D011241:Prednisone