Pregnancy outcomes in women with juvenile idiopathic arthritis: a population-based study

Abstract

Objective: The aim of this study is to describe pregnancy outcomes among women with JIA.

Methods: Women who gave birth in New South Wales (NSW), Australia, were linked to hospital discharge records from 2000 to 2010. Women with an ICD-10-AM code of M08 or M09 in the hospital records were considered to have JIA. Logistic regression was used to calculate odds ratios for pregnancy outcomes and the lack of independence in study outcomes for multiple pregnancies in the same woman was taken into account using generalized estimating equations.

Results: During the study period, 601,659 women had 941,496 births. Of these births, 78 births could be attributed to 50 women with JIA. Of 78 JIA pregnancies, 53 (68%) were delivered by either Caesarean section (n = 40, 51%) or instrumental delivery (n = 13, 17%); compared with other women, those with JIA had significantly higher rates of pre-eclampsia, postpartum haemorrhage and severe maternal morbidity. Compared with other infants, those with mothers with JIA were more likely to be born prematurely, but were not at increased risk of being small for gestational age, requiring neonatal intensive care, having a low Apgar score at 5 min or severe neonatal morbidity.

Conclusion: Infants of women with JIA did not have an increased risk of adverse neonatal outcomes. Intensive obstetric care might be required during pregnancy for women with JIA given the increased risk of maternal morbidity.

Keywords: juvenile idiopathic arthritis; outcomes research; pregnancy; rheumatoid arthritis.