Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review

Mokbel, Abir; Lawson, Daeria O.; Farrokhyar, Forough

doi:10.1007/s10067-021-05588-9

Cited by 18 publications

(27 citation statements)

References 60 publications

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“…Furthermore, the proportion of stillbirths in women with axSpA was comparable with controls (0.5% vs 0.4%), which is in line with national statistics (0.4% 13 ) and was also reported in the latest reviews and meta-analyses. [2][3][4] There was also no difference observed for gestational diabetes, consistent with previous results. [2][3][4] Altogether congenital malformations were comparable between infants from axSpA pregnancies (8.5%) and from control pregnancies (9.0%).…”

Section: Discussionsupporting

confidence: 92%

“…[2][3][4] There was also no difference observed for gestational diabetes, consistent with previous results. [2][3][4] Altogether congenital malformations were comparable between infants from axSpA pregnancies (8.5%) and from control pregnancies (9.0%). These proportions are higher than the 6.5% reported in literature, 17 which is likely due to our less restrictive adaptation of the classification criteria of EUROCAT.…”

Section: Discussionsupporting

confidence: 92%

“…Our study confirms one of the main findings of latest reviews and meta-analyses regarding the increased odds of CS. [2][3][4] Both elective and emergency CS were more common in women with axSpA than in controls. However, our explanatory analyses by treatment group showed that the risk of emergency CS in comparison with controls was only increased in women with axSpA under treatment with bDMARDs, who were more likely than controls to deliver by emergency CS.…”

Section: Discussionmentioning

confidence: 98%

“…Despite the increased number of studies published in the past decade, the latest literature reviews and metaanalyses highlight the dire need for further research on the outcomes of pregnancy in axSpA due to the large heterogeneity among present studies. [2][3][4] Moreover, it is pointed out that large cohorts of women with axSpA are required and a special focus should be on pharmacological treatment during pregnancy.…”

Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 99%

“…In recent years, interest in pregnancy outcomes in axial spondyloarthritis (axSpA), a chronic inflammatory rheumatic disease that predominantly affects the spine and/ or sacroiliac joints, 1 has increased as demonstrated by the latest literature reviews and meta-analyses. [2][3][4][5] One of their main results is the increased prevalence of caesarean sections (CSs) compared with the general population. Preterm birth also showed a significant trend towards increased prevalence in axSpA pregnancies.…”

Section: Introductionmentioning

confidence: 99%

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Maternal and infant outcomes in pregnancies of women with axial spondyloarthritis compared with matched controls: results from nationwide health insurance data

et al. 2022

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ObjectivesTo investigate pregnancy outcomes in women with axial spondyloarthritis (axSpA) under different pharmacological treatments in comparison with matched controls.MethodsUsing health insurance data from 2006 to 2019, pregnancy outcomes of women with axSpA were compared with those of age-matched and calendar year-matched controls without axSpA. Women with axSpA were further stratified by treatment prior to delivery and pregnancy outcomes compared. Adjusted ORs (aORs) with 95% CIs were calculated using generalised estimating equation analyses.ResultsA total of 1021 pregnancy outcomes in patients with axSpA were identified (928 deliveries, 80 abortions, 13 ectopic pregnancies) and compared with 10 210 pregnancy outcomes in controls (9488 deliveries, 615 abortions, 147 ectopic pregnancies). Compared with controls, women with axSpA showed higher odds of elective caesarean section (aOR 1.52; 1.25 to 1.85).Among women with axSpA, the risk of preterm birth was higher under non-steroidal anti-inflammatory drugs (NSAIDs) treatment (aOR 2.22; 1.09 to 4.52) than without any anti-inflammatory treatment. The risks of preterm birth (aOR 4.01; 1.93 to 8.34) and small-for-gestational-age (aOR 3.22; 1.34 to 7.73) were increased under NSAIDs treatment in combination with conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), steroids or analgesics. Non-significant increased risks of small-for-gestational-age (aOR 1.68; 0.43 to 6.57) and preterm birth (aOR 1.56; 0.51 to 4.83) were found under biological DMARDs.ConclusionsWomen with axSpA have significantly increased odds of caesarean section compared with matched controls. Risks of preterm birth and small-for-gestational-age vary by type of anti-inflammatory treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Maternal and infant outcomes in pregnancies of women with axial spondyloarthritis compared with matched controls: results from nationwide health insurance data

et al. 2022

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Assessment of fetal pulmonary artery Doppler indices in pregnant women with rheumatoid arthritis and ankylosing spondylitis

Beşer

Oluklu

Hendem

et al. 2023

J of Clinical Ultrasound

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Purpose To investigate fetal pulmonary artery Doppler parameters in pregnant women with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods This case–control study included 24 pregnant women diagnosed with 13 AS and 11 RA and 48 healthy pregnant women at 29–30 weeks of gestation. The demographic and clinical features were recorded, including disease type and duration, attacks during pregnancy, and medications. Pulmonary artery acceleration time (AT), ejection time (ET), and pulmonary artery acceleration time to ejection time (PATET) ratio were measured by manual trace with spectral Doppler ultrasound. Results A shorter pulmonary AT and lower PATET ratio were found in the case group (34.8 ± 2.3, p < 0.001, 0.18 ± 0.02, p < 0.001, respectively). When comparing the groups that had an attack during pregnancy and had not, there were no significant differences in the pulmonary artery indices. We also demonstrated a moderate correlation between maternal disease years and the PATET ratio (r = −0.562, p = 0.004). Conclusion This is the first study to evaluate the effect of RA and AS on fetal pulmonary indices. Maternal inflammation might affect pulmonary development and circulation. Fetal pulmonary Doppler indices can be used to obtain further information about neonatal respiratory morbidities in rheumatological disorders.

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Reduced T2*-weighted placental MRI predicts foetal growth restriction in women with chronic rheumatic disease—a Danish explorative study

Vestergaard,

Julsgaard,

Helmig

et al. 2024

Clin Rheumatol

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Objectives Women with chronic rheumatic disease (CRD) are at greater risk of foetal growth restriction than their healthy peers. T2*-weighted magnetic resonance imaging of placenta (T2*P-MRI) is superior to conventional ultrasonography in predicting birth weight and works as a proxy metabolic mirror of the placental function. We aimed to compare T2*P-MRI in pregnant women with CRD and healthy controls. In addition, we aimed to investigate the correlation between T2*P-MRI and birth weight. Methods Using a General Electric (GE) 1.5 Tesla, we consecutively performed T2*-weighted placental MRI in 10 women with CRD and 18 healthy controls at gestational week (GW)24 and GW32. We prospectively collected clinical parameters during pregnancy including birth outcome and placental weight. Results Women with CRD had significantly lower T2*P-MRI values at GW24 than healthy controls (median T2*(IQR) 92.1 ms (81.6; 122.4) versus 118.6 ms (105.1; 129.1), p = 0.03). T2*P-MRI values at GW24 showed a significant correlation with birth weight, as the T2*P-MRI value was reduced in all four pregnancies complicated by SGA at birth. Three out of four pregnancies complicated by SGA at birth remained undetected by routine antenatal ultrasound. Conclusion This study demonstrates reduced T2*P-MRI values and a high proportion of SGA at birth in CRD pregnancies compared to controls, suggesting an increased risk of placental dysfunction in CRD pregnancies. T2*P-MRI may have the potential to focus clinical vigilance by identifying pregnancies at risk of SGA as early as GW24. Key Points• Placenta-related causes of foetal growth restriction in women with rheumatic disease remain to be investigated.• T2*P-MRI values at gestational week 24 predicted foetuses small for gestational age at birth.• T2*P-MRI may indicate pregnant women with chronic rheumatic disease (CRD) in need of treatment optimization.

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Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review

Cited by 18 publications

References 60 publications

Maternal and infant outcomes in pregnancies of women with axial spondyloarthritis compared with matched controls: results from nationwide health insurance data

Maternal and infant outcomes in pregnancies of women with axial spondyloarthritis compared with matched controls: results from nationwide health insurance data

Assessment of fetal pulmonary artery Doppler indices in pregnant women with rheumatoid arthritis and ankylosing spondylitis

Reduced T2*-weighted placental MRI predicts foetal growth restriction in women with chronic rheumatic disease—a Danish explorative study

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