Retrospective evaluation of pregnancies with ankylosing spondylitis in a tertiary center in Turkey

Abstract

Background To evaluate obstetrical and perinatal outcomes of pregnancies with ankylosing spondylitis (AS). Methods This was a retrospective study evaluating obstetric outcomes of 52 patients with AS who were followed up at our institution between 2006 and 2019. Patients were classified as having disease greater than or less than 5 years, and according to disease‐related medical treatment during pregnancy, as drug free, single medication or multiple medication. Results Overall rates of preterm delivery, intrauterine growth retardation and preeclampsia were 17.3%, 13.4% and 7.7%, respectively. Thirty‐three of the patients were followed up without any medication, while 19 patients used drugs during pregnancy. Seven patients used a single drug and 12 patients had multiple drugs. There was no significant difference in terms of obstetrical and neonatal outcomes. However, a higher rate of neonatal intensive care unit (NICU) admission was observed in the group using medication for AS, despite a lack of statistical significance (31.5% vs 15%, P = .162). On the other hand, patients having disease more than 5 years had higher rates of Apgar scores less than <7 and admission to the NICU despite a lack of statistical significance (4% vs 7.4% and 16% vs 26%; P = .267 and P = .297, respectively). Conclusion In conclusion, pregnancies of patients with AS must be considered as high risk due to increased rates of adverse outcomes such as preterm delivery, intrauterine growth retardation or preeclampsia.

Impact of hydroxychloroquine on the gestational outcomes of pregnant women with immune system problems that necessitate the use of the drug

“…Immune system problems, such as autoimmune disorders, chronic inflammatory diseases and autoimmune antibody positivities, are all risk factors for the endothelial injury of vascular structures of placenta, thrombosis, destruction of the cellular structures of the intervillous space of placenta and placental inflammation during the course of pregnancy. [1][2][3][4][5][6][7][8][9] Concomitantly, these immune system problems are associated with adverse obstetric complications and increased perinatal morbidity/mortality. [1][2][3][4][5][6][7][8][9] For this reason, women having such immune system problems should take the necessary precautions before getting pregnant and during their pregnancies to avoid experiencing relevant complications.…”

Maternal and neonatal pregnancy outcomes in ankylosing spondylitis

“…C. Unal и соавт. [12] на основании анализа исходов беременности у 52 пациенток с АС рассматривают беременность при АС как беременность «высокого риска» из-за увеличения частоты преждевременных родов (17,3%) и преэклампсии (7,7%). Сходные данные получены S. Mork и соавт.…”

“…Мнение исследователей о неонатальных исходах беременности также неоднозначно. Ряд авторов считает, что при АС имеет место повышение риска задержки внутриутробного развития плода (ЗВРП) и низкой массы тела новорожденных, не соответствующей гестационному возрасту [12,13]. В группе больных АС, описанной C Unal и соавт.…”

“…В группе больных АС, описанной C Unal и соавт. [12], частота ЗВРП составила 13,4%, что больше, чем в общей популяции (5,2-12%). Кроме этого, имелась тенденция к более высокой частоте госпитализации новорожденных в отделение интенсивной терапии новорожденных, матери которых во время беременности продолжали медикаментозную терапию АС (31,5%).…”

“…Тем не менее информация о влиянии АС на течение и исходы беременности продолжает оставаться противоречивой. Хотя большинство авторов считает, что АС не оказывает отрицательного влияния на исходы беременности (за исключением повышения частоты кесарева сечения, КС) [3, 6, 8-11], в ряде работ показано увеличение встречаемости преждевременных родов, преэклампсии, задержки развития плода, низкой массы тела новорожденных у женщин с АС по сравнению с популяционным контролем [7,12,13].…”