Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy

Man, Yaël A de; Bakker-Jonges, Liesbeth E.; Goorbergh, C M Dufour-van den; Tillemans, S P R; Hooijkaas, Herbert; Hazes, Johanna M. W.; Dolhain, Radboud J E M

doi:10.1136/ard.2008.104331

Cited by 99 publications

(46 citation statements)

References 11 publications

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“…9 However, women with positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) appear to be less likely to improve during pregnancy. 10 Most women with psoriatic arthritis (PsA) generally improve or even remit during pregnancy, whereas the symptoms of most women with ankylosing spondylitis (AS) remain unaltered or worsen during pregnancy.…”

Section: Rheumatoid Arthritis and Other Chronic Inflammatory Arthritidesmentioning

confidence: 99%

Connective tissue disease in pregnancy

Ateka-Barrutia

Nelson‐Piercy

2013

Clinical Medicine

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-Connective tissue diseases (CTD) include a variety of chronic multisystem disorders with a high percentage of autoimmune conditions. Many of these conditions affect women of childbearing age and, therefore, pregnancy poses an important challenge for doctors looking after such women. Knowledge of medication safety, the effect of pregnancy on such diseases and vice versa, together with preconception counselling and multidisciplinary team care, are the basic pillars needed to provide the best obstetric and medical care to these women. In this review, we discuss the management of the most common autoimmune CTD before, during and after pregnancy, along with the most relevant issues regarding appropriate medication.

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Section: Rheumatoid Arthritis and Other Chronic Inflammatory Arthritidesmentioning

confidence: 99%

Connective tissue disease in pregnancy

Ateka-Barrutia

Nelson‐Piercy

2013

Clinical Medicine

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“…These findings could have major influences on the future health of the child (3,7). Studies have indicated that there is a potential risk of a less favorable birth outcome, such as low birth weight or shorter gestational age, in women with RA (1,2). This is the first study that searched beyond birth outcome and explored the postnatal effect of RA during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…In pregnant women with rheumatoid arthritis (RA), the extent of disease activity, use of medications, and presence of rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPAs) are related, directly and indirectly, to lower birth weight of the child (1,2). When a child is born with a lower birth weight, catch-up growth may occur, and the tempo of this catch-up is important (1).…”

mentioning

confidence: 99%

Rheumatoid Arthritis During Pregnancy and Postnatal Catch‐Up Growth in the Offspring

Steenwinkel

Hokken-Koelega

Ridder

et al. 2014

Arthritis & Rheumatology

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Objective. Active rheumatoid arthritis (RA) during pregnancy and the presence of rheumatoid factor (RF) or anti-citrullinated protein antibodies (ACPAs) are associated with lower birth weight of the child. Moreover, treatment of the mothers with prednisone may shorten the gestational age at birth. Rapid catch-up in weight for length during the first year of life has been related to a worse cardiovascular and metabolic profile in early adulthood. This study was therefore undertaken to assess the influence of RA disease activity, medication use, and presence of RF or ACPAs during pregnancy on the growth of the child in the first year of life.Methods. Among 180 children born to mothers with RA, the tempo of catch-up in weight during the first year of life was studied. Independent variables were the extent of RA disease activity (according to the Disease Activity Score in 28 joints [DAS28]), medication use, and presence of RF or ACPAs during pregnancy.Results. Of 167 children with available data, 52 (31%) showed catch-up in weight in the first year of life, of whom 90% (47 of 52) showed rapid catch-up. An elevated DAS28 score in the mother was associated with rapid catch-up in weight of the offspring, independent of maternal medication use or the presence of RF or ACPAs during pregnancy (odds ratio 1.44 [95% confidence interval 1.07-1.95] per 1-point increase in the DAS28). Use of medications during pregnancy had no influence on postnatal growth.Conclusion. Elevated RA disease activity during pregnancy should be avoided because it is associated with rapid postnatal catch-up in weight, a risk factor for a worse cardiovascular and metabolic profile in adults. Medication for RA during pregnancy, including prednisone, had no effect on growth. Continuation or extension of medication will not only improve maternal health during pregnancy, but could be beneficial for the future health of the unborn child.

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“…Попытки обнаружить предикторы, позволяющие прогнозировать течение РА во время беременности, после родов и в более отдаленные сроки, не дали желаемых ре-зультатов. Вместе с тем следует отметить, что у женщин, негативных по ревматоидному фактору (РФ) и антителам к циклическому цитруллинированному пептиду (АЦЦП), чаще наблюдалось снижение активности РА в период бере-менности [13]. Симптомы РА стихали у 75% женщин, нега-тивных по АЦЦП и РФ, и только у 39% позитивных по ука-занным антителам.…”

Section: влияние беременности на ревматоидный артритunclassified

Rheumatoid Arthritis and Pregnancy

Кошелева¹,

Matianova²

2014

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Ревматоидный артрит (РА) обычно начинается в том возрасте, когда вопрос материнства для многих жен-щин уже решен, однако он может дебютировать в детском и подростковом возрасте. Кроме того, в послед-ние годы прослеживается тенденция планирования беременности женщинами в более зрелом возрасте, что диктует необходимость обсуждения проблемы гестации при данном заболевании. Изучение механизмов вли-яния беременности на развитие РА как в период гестации, так и в отдаленные сроки имеет важное теорети-ческое и практическое значение. Результаты таких исследований могут быть использованы при разработке новых методов лечения РА и тактики ведения больных в период беременности и лактации. В статье приведе-ны данные литературы о фертильности при РА, влиянии беременности на активность РА и последнего на те-чение и исходы гестации, представлены современные воззрения на лактацию и применение оральных конт-рацептивов при РА. Особое внимание уделено лекарственной терапии беременных и кормящих женщин с РА: подробно рассмотрены группы антиревматических препаратов в соответствии с безопасностью или по-тенциальным риском их применения. Предложены терапевтический алгоритм и рекомендации по планиро-ванию беременности и наблюдению за пациентками с РА в период гестации. Ключевые слова: ревматоидный артрит; беременность; фертильность; лактация; лекарственная терапия. Для ссылки: Кошелева НМ, Матьянова ЕВ. Ревматоидный артрит и беременность. Научно-практическая ревматология. 2014;52(6):589-599. RHEUMATOID ARTHRITIS AND PREGNANCYKosheleva N.M., Matyanova E.V.Rheumatoid arthritis (RA) generally starts at the age when many women have already become mothers; however, it may occur in childhood or adolescence. Furthermore, there has been recently a women's tendency to plan pregnacy for a more mature age, which necessitates a discussion about gestation in this disease. Investigation of mechanisms pregnancy can influence the development of RA both in the gestation and long-term periods is of important theoretical and practical value. The results of these investigations may be used to develop new treatments for RA and management tactics for patients during pregnancy and lactation. The paper gives the data available in the literature on fertility in RA, impact of pregnancy on its activity and that of RA on the course and outcomes of gestation, as well as current ideas on lactation and use of oral contraceptives in RA. Particular attention is given to drug therapy in pregnant and breastfeeding women with RA: groups of anti-rheumatic drugs are considered in detail in relation to the safety of or a potential risk from their use. A therapeutic algorithm and recommendations for pregnancy planning and a follow-up of patients with RA during gestation are proposed.

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Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy

Abstract: Improvement of disease activity of RA during pregnancy was not associated with changes in levels of autoantibodies during pregnancy, however, improvement may occur more frequently in the absence of anti-CCP and RF.

Cited by 99 publications

References 11 publications

Connective tissue disease in pregnancy

Connective tissue disease in pregnancy

Rheumatoid Arthritis During Pregnancy and Postnatal Catch‐Up Growth in the Offspring

Rheumatoid Arthritis and Pregnancy

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