Rheumatic Diseases in Reproductive Age—the Possibilities and the Risks

Grygiel-Górniak, Bogna; Masiero, Elena; Nevaneeth, Briana Candace; Jojy, Melissa Mary

doi:10.1007/s43032-022-00901-6

Cited by 6 publications

(2 citation statements)

References 83 publications

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“…Compared with the general obstetric population, pregnant women with MSK disorders have higher risk in developing adverse maternal, neonatal and fetal outcomes including gestational hypertension, pre-eclampsia, caesarean delivery, preterm delivery, low birth weight, congenital anomalies, stillborn, etc ,29 30 which may be associated with medication use and disease activity 30. Moreover, the flare of MSK disorders may coexist with these complications, and difficulties in differential diagnosis are raised 31. Therefore, close monitoring of clinical status, control of disease activity and proper adjustment of medication regimen, are extremely vital for women with MSK disorders before and during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Global, regional and national temporal trends in prevalence for musculoskeletal disorders in women of childbearing age, 1990–2019: an age-period-cohort analysis based on the Global Burden of Disease Study 2019

Cao,

Li,

et al. 2023

Ann Rheum Dis

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ObjectivesTo provide an overview and in-depth analysis of temporal trends in prevalence of musculoskeletal (MSK) disorders in women of childbearing age (WCBA) at global, regional and national levels over the last 30 years, with a special focus on their associations with age, period and birth cohort.MethodsEstimates and 95% uncertainty intervals (UIs) for MSK disorders prevalence in WCBA were extracted from the Global Burden of Diseases, Injuries and Risk Factors Study 2019. An age-period-cohort model was adopted to estimate the overall annual percentage change of prevalence (net drift, % per year), annual percentage change of prevalence within each age group (local drift, % per year), fitted longitudinal age-speciﬁc rates adjusted for period deviations (age effects) and period/cohort relative risks (period/cohort effects) from 1990 to 2019.ResultsIn 2019, the global number of MSK disorders prevalence in WCBA was 354.57 million (95% UI: 322.64 to 387.68). Fifty countries had at least one million prevalence, with India, China, the USA, Indonesia and Brazil being the highest accounting for 51.03% of global prevalence. From 1990 to 2019, a globalnet driftof MSK disorders prevalence in WCBA was −0.06% (95% CI: −0.07% to −0.05%) per year, ranging from −0.09% (95% CI: −0.10% to −0.07%) in low-middle sociodemographic index (SDI) region to 0.10% (95% CI: 0.08% to 0.12%) in high-middle SDI region, with 138 countries presenting increasing trends, 24 presenting decreasing trends and 42 presenting relatively flat trends. As reflected bylocal drift, higher SDI regions had more age groups showing rising prevalence whereas lower SDI regions had more declining prevalence. Globally, an increasing occurrence of MSK disorders prevalence in WCBA beyond adolescent and towards the adult stage has been prominent. Age effects illustrated similar patterns across different SDI regions, with risk increasing with age. High SDI region showed generally lower period risks over time, whereas others showed more unfavourable period risks. High, high-middle and middle SDI regions presented unfavourable prevalence deteriorations, whereas others presented favourable prevalence improvements in successively birth cohorts.ConclusionsAlthough a favourable overall temporal trend (net drift) of MSK disorders prevalence in WCBA was observed over the last 30 years globally, there were 138 countries showing unfavourable rising trends, coupled with deteriorations in period/cohort risks in many countries, collectively raising concerns about timely realisation of the Targets of Sustainable Development Goal. Improvements in the MSK disorders-related prevention, management and treatment programmes in WCBA could decline the relative risk for successively younger birth cohorts and for all age groups over period progressing.

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Section: Discussionmentioning

confidence: 99%

Global, regional and national temporal trends in prevalence for musculoskeletal disorders in women of childbearing age, 1990–2019: an age-period-cohort analysis based on the Global Burden of Disease Study 2019

Cao,

Li,

et al. 2023

Ann Rheum Dis

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“…Before and throughout pregnancy, only medications that do not increase the risk of fetal problems should be administered. Teratogenic medicines (such as methotrexate, leflunomide, and cyclophosphamide) must be discontinued before conception 12 .…”

Section: Discussionmentioning

confidence: 99%

Fetal and Neonatal Outcomes of Maternal Rheumatic diseases in a tertiary care centre of Lahore, Pakistan

Aslam¹,

Yasin²,

Ullah³

et al. 2023

PJMHS

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Background: Pregnancy may worsen underlying autoimmune rheumatologic illnesses. The trans-placental transmission of autoantibodies can harm the foetus or newborn. Aim: To determine the impact of maternal rheumatological disorders on fetal and newborn outcomes. Methods: A descriptive longitudinal study was conducted at Fatima Memorial Hospital enrolling 32 pregnant women with rheumatologic disorders by consecutive sampling. Data was collected regarding maternal demographics, diagnosis, serum markers, Fetal & neonatal outcome factors (IUGR, Fetal distress, Umbilical Doppler findings, Fetal Echo, Place of birth, Mode of delivery, discharge status, Term/pre-term birth, Gender, Low Birth Weight, Cardiac defect, NICU stay, the reason for NICU stay) Results: The diagnosis of 50% of the subjects was SLE. 25%subjects were suffering from RA. Regarding serum markers, 50% of the mothers were Anti ds DNA positive followed by ANA with 34.4% & Lupus anticoagulant with 21.9% positivity. IUGR was recorded in 9.4%, fetal distress in 28.1%, abnormal umbilical doppler in 9.4%, and 12.5% of a newborn could not survive. Pre-term delivery was recorded in 31.3% of cases, low birth weight in 34.4%, cardiac defects in 6.3%, thrombocytopenia in 6.3%, NICU stay was required in 31.3%, EOS was reason in 12.5% and RDS in 25%. Conclusion: Prevalence of IUGR, fetal distress, low birth weight, preterm delivery, cardiac defects and admission to NICU was high in autoimmune rheumatological pregnant females. Pre-term delivery, fetal distress and LBW were significantly associated with SLE. Keywords: Pregnancy outcome, rheumatic disease outcome, fetus, neonate, SLE

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Reply to letter to the editor: “Why 43.5% of Brazilian women with systemic sclerosis have an abnormal 6-min walk distance? The implication of parity”

de Oliveira Saraiva,

de Oliveira Farias,

dos Santos

et al. 2023

Clinical Biomechanics

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Rheumatic Diseases in Reproductive Age—the Possibilities and the Risks

Cited by 6 publications

References 83 publications

Global, regional and national temporal trends in prevalence for musculoskeletal disorders in women of childbearing age, 1990–2019: an age-period-cohort analysis based on the Global Burden of Disease Study 2019

Global, regional and national temporal trends in prevalence for musculoskeletal disorders in women of childbearing age, 1990–2019: an age-period-cohort analysis based on the Global Burden of Disease Study 2019

Fetal and Neonatal Outcomes of Maternal Rheumatic diseases in a tertiary care centre of Lahore, Pakistan

Reply to letter to the editor: “Why 43.5% of Brazilian women with systemic sclerosis have an abnormal 6-min walk distance? The implication of parity”

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