title: Is Disease Activity in Rheumatoid Arthritis during Pregnancy and after Delivery Predictive for Disease Activity in a Subsequent Pregnancy?
abstract: OBJECTIVE
  To determine whether disease activity in women with rheumatoid arthritis (RA) in 1 pregnancy is predictive for disease activity in a subsequent pregnancy.
  
  
  METHODS
  In the Pregnancy-induced Amelioration of Rheumatoid Arthritis study, there are prospective data on 27 patients who participated twice. Improvement and deterioration is determined by changes in the Disease Activity Score in 28 joints.
  
  
  RESULTS
  Only 4 patients (14.8%) had comparable disease courses in both pregnancies, whereas treatment remained mostly similar. In contrast, a flare postpartum after the first pregnancy was predictive for a flare after the second pregnancy (p = 0.003).
  
  
  CONCLUSIONS
  RA disease course in following pregnancies cannot be predicted based upon previous pregnancies. However, a flare postpartum seems to predict subsequent flares.
authors.affiliation: From the Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands.H. Ince-Askan, MD, Department of Rheumatology, Erasmus Medical Center; J.M. Hazes, MD, PhD, Department of Rheumatology, Erasmus Medical Center; R.J. Dolhain, MD, PhD, Department of Rheumatology, Erasmus Medical Center. h.ince-askan@erasmusmc.nl.
authors.forename: Hilal
authors.initials: H
authors.lastname: Ince-Askan
authors.affiliation: From the Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands.H. Ince-Askan, MD, Department of Rheumatology, Erasmus Medical Center; J.M. Hazes, MD, PhD, Department of Rheumatology, Erasmus Medical Center; R.J. Dolhain, MD, PhD, Department of Rheumatology, Erasmus Medical Center.
authors.forename: Johanna M W
authors.initials: JM
authors.lastname: Hazes
authors.affiliation: From the Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands.H. Ince-Askan, MD, Department of Rheumatology, Erasmus Medical Center; J.M. Hazes, MD, PhD, Department of Rheumatology, Erasmus Medical Center; R.J. Dolhain, MD, PhD, Department of Rheumatology, Erasmus Medical Center.
authors.forename: Radboud J E M
authors.initials: RJ
authors.lastname: Dolhain
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D010298:Parity; D049590:Postpartum Period; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index
keywords: DISEASE ACTIVITY; PREGNANCY; RHEUMATOID ARTHRITIS