title: Pregnancy outcome in joint hypermobility syndrome and Ehlers-Danlos syndrome.
abstract: BACKGROUND
  An increased risk of preterm birth in women with joint hypermobility syndrome or Ehlers-Danlos syndrome is suspected.
  
  
  METHODS
  In this nationwide cohort study from 1997 through 2011, women with either joint hypermobility syndrome or Ehlers-Danlos syndrome or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby, 314 singleton births to women with joint hypermobility syndrome/Ehlers-Danlos syndrome before delivery were identified. These births were compared with 1 247 864 singleton births to women without a diagnosis of joint hypermobility syndrome/Ehlers-Danlos syndrome. We used logistic regression, adjusted for maternal age, smoking, parity, and year of birth, to calculate adjusted odds ratios for adverse pregnancy outcomes.
  
  
  RESULTS
  Maternal joint hypermobility syndrome/Ehlers-Danlos syndrome was not associated with any of our outcomes: preterm birth (adjusted odds ratio = 0.6, 95% confidence interval 0.3-1.2), preterm premature rupture of membranes (adjusted odds ratio = 0.8; 95% confidence interval 0.3-2.2), cesarean section (adjusted odds ratio = 0.9, 95% confidence interval 0.7-1.2), stillbirth (adjusted odds ratio = 1.1, 95% confidence interval 0.2-7.9), low Apgar score (adjusted odds ratio = 1.6, 95% confidence interval 0.7-3.6), small for gestational age (adjusted odds ratio = 0.9, 95% confidence interval 0.4-1.8) or large for gestational age (adjusted odds ratio = 1.2, 95% confidence interval 0.6-2.1). Examining only women with Ehlers-Danlos syndrome (n = 62), we found a higher risk of induction of labor (adjusted odds ratio = 2.6; 95% confidence interval 1.4-4.6) and amniotomy (adjusted odds ratio = 3.8; 95% confidence interval 2.0-7.1). No excess risks for adverse pregnancy outcome were seen in joint hypermobility syndrome.
  
  
  CONCLUSIONS
  Women with joint hypermobility syndrome/Ehlers-Danlos syndrome do not seem to be at increased risk of adverse pregnancy outcome.
authors.affiliation: Department of Pediatrics, University Hospital, Linköping, Sweden.
authors.forename: Heléne E K
authors.initials: HE
authors.lastname: Sundelin
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Institute, Stockholm, Sweden.|School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Olof
authors.initials: O
authors.lastname: Stephansson
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Institute, Stockholm, Sweden.
authors.forename: Kari
authors.initials: K
authors.lastname: Johansson
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.|Department of Pediatrics, University Hospital, Örebro, Sweden.|Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004535:Ehlers-Danlos Syndrome / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000151:congenital* / Q000453:epidemiology; D007751:Labor, Induced / Q000706:statistics & numerical data; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Ehlers-Danlos syndrome; Joint hypermobility syndrome; child; obstetric - cohort study; pregnancy