Obstetric outcomes in women with rheumatoid arthritis: Results from Nationwide Inpatient Sample Database 2003–2011✰

Kishore, Shweta; Mittal, Varun; Majithia, Vikas

doi:10.1016/j.semarthrit.2019.03.011

Cited by 41 publications

(24 citation statements)

References 17 publications

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“…Further multivariate analyses confirmed the association with hypertensive disorder and SGA. These findings are in line with several previous studies in patients with RA that showed similar pregnancy outcomes 6,7,8 .…”

supporting

confidence: 93%

“…Accordingly, many female patients with IA are in their childbearing years and the interplay between the inflammatory arthritic disease and pregnancy is a matter of concern. To date, most of the information in this field derives from studies conducted in patients with RA, and unfortunately the gestational data regarding those who have other types of IA are scarce 6,7,8 .…”

mentioning

confidence: 99%

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Pregnancy Outcome in Inflammatory Arthropathies — Are Population Database Studies the Right Tool?

Polachek

Eder

2020

J Rheumatol

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supporting

confidence: 93%

mentioning

confidence: 99%

Pregnancy Outcome in Inflammatory Arthropathies — Are Population Database Studies the Right Tool?

Polachek

Eder

2020

J Rheumatol

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“…Las madres gestantes portadoras de AR tienen un mayor riesgo de eclampsia, parto por cesárea y parto prematuro 17 . un estudio sueco en mujeres embarazadas con artritis idiopática juvenil (AIJ) presentó un mayor riesgo de complicaciones maternas e infantiles en comparación con los controles de la población 18 .…”

Section: Valor De La Ecografía En La Artritis Reumatoide Activa Durante El Embarazounclassified

Rheumatoid Arthritis and Pregnancy. Upgrade

Rojas

Cabrera-Villalba

2020

Rev. parag. reumatol

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La Artritis Reumatoide (AR) es una afección autoinmune inflamatoria crónica frecuente, que se caracteriza por la inflamación persistente de las articulaciones sinoviales. Encarar el tratamiento de la AR en el embarazo resulta complejo atendiendo a la necesidad de una interacción correcta entre el monitoreo de la actividad de la enfermedad y la mitigación de los síntomas con terapias no tóxicas pero eficaces. Durante el embarazo se puede observar una disminución de la actividad de la enfermedad, entre el 48 % al 86 %. Algunas pacientes con AR podrían desarrollar mayor actividad de la enfermedad, así como partos prematuros, bajo peso del niño al nacer e incluso abortos. Los AINEs podrían elevar el riesgo de subfertilidad en las pacientes con AR. La Hidroxicloroquina, así como la Sulfasalazina, se pueden administrar de manera segura durante todo el embarazo. Los glucocorticoides a dosis mayores a 7,5 se asociaron con parto prematuro. Durante el 1er trimestre del embarazo el uso de anti-TNF de manera continua está recomendada. Tanto la Leflunomida como el Metotrexate se deben suspende cuando se desea un embarazo.

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“…Several studies did not include ICD‐9 code 649.1x to define obesity, which indicates complications of pregnancy attributed to obesity and was the most commonly used code in our data; this likely resulted in even greater bias as the specificity of their codes would have been even lower than what we found. Other studies have indicated that ICD‐9 codes were used to define obesity but did not list the specific codes used, making it impossible to know how biased their definition was . Regardless, the low sensitivity of ICD‐9 codes for identifying pregnant individuals with obesity suggests substantial misclassification.…”

Section: Commentmentioning

confidence: 99%

Defining maternal obesity in studies of birth outcomes: Comparing ICD‐9 codes at delivery and measures on the birth certificate

Wall‐Wieler

Abrams

Snowden

et al. 2020

Paediatric Perinatal Epid

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Background Using ICD‐9 codes underestimates the prevalence of obesity in adults; however, the validity of these codes in studies of pregnancy‐related outcomes is not known. Objectives To compare classification of maternal obesity based on ICD‐9 codes in hospital discharge records versus data from birth certificates in the same women, examine predictors of agreement, and assess how associations between obesity and two birth outcomes differ by source of weight data. Methods This population‐based study included 2 329 145 California births between 2007 and 2012. We compared data on obesity from childbirth hospital discharge records (ICD‐9 codes for obesity) and birth certificates (pre‐pregnancy body mass index (BMI) calculated from weight and height) and identified predictors of agreement between the two sources. Logistic regression models assessed whether the two definitions of obesity resulted in different estimates of the associations of obesity with caesarean birth and large‐for‐gestational age. Results Overall, 464 754 women (20.0%) had obesity based on their pre‐pregnancy BMI while only 100 002 (4.3%) had an obesity‐related ICD‐9 code. The sensitivity of ICD‐9‐based obesity was low at 16.2%; however, obesity codes were highly specific at 98.7%, with a negative predictive value of 82.5% and a positive predictive value of 75.2%. Among women with obesity identified by the birth certificate, those with pre‐pregnancy and pregnancy‐related complications (eg diabetes and hypertension) were more likely to have an obesity‐related diagnosis in their delivery hospital discharge record. Using ICD‐9 codes overestimated the association of obesity with caesarean birth and newborn large‐for‐gestational age. Conclusions ICD‐9 codes in childbirth discharge records captured only one in five women with pre‐pregnancy obesity. Sensitivity varied by maternal characteristics and conditions. This misclassification resulted in bias when examining the association of obesity and pregnancy‐related outcomes.

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Obstetric outcomes in women with rheumatoid arthritis: Results from Nationwide Inpatient Sample Database 2003–2011✰

Cited by 41 publications

References 17 publications

Pregnancy Outcome in Inflammatory Arthropathies — Are Population Database Studies the Right Tool?

Pregnancy Outcome in Inflammatory Arthropathies — Are Population Database Studies the Right Tool?

Rheumatoid Arthritis and Pregnancy. Upgrade

Defining maternal obesity in studies of birth outcomes: Comparing ICD‐9 codes at delivery and measures on the birth certificate

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