Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project

Balambal Bharti¹, Susan J Lee², Suzanne P Lindsay², Deborah L Wingard², Kenneth L Jones², Hector Lemus², Christina D Chambers²

Affiliations

¹ From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego. bbharti@ucsd.edu.
² From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego.

PMID: 25877497
DOI: 10.3899/jrheum.140583

Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project

Balambal Bharti et al. J Rheumatol. 2015 Aug.

. 2015 Aug;42(8):1376-82.

doi: 10.3899/jrheum.140583. Epub 2015 Apr 15.

Authors

Balambal Bharti¹, Susan J Lee², Suzanne P Lindsay², Deborah L Wingard², Kenneth L Jones², Hector Lemus², Christina D Chambers²

Affiliations

¹ From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego. bbharti@ucsd.edu.
² From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego.

PMID: 25877497
DOI: 10.3899/jrheum.140583

Abstract

Objective: To determine the effect of rheumatoid arthritis (RA) disease severity on pregnancy outcomes in pregnant women with and without autoimmune diseases.

Methods: A prospective cohort study was conducted using the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. Pregnant women with RA enrolled between 2005 and 2013 were selected if they (1) delivered a live-born singleton infant; and (2) completed 3 telephone-based measures of RA disease severity prior to 20 weeks' gestation, including the Health Assessment Questionnaire Disability Index (HAQ-DI), pain score, and patient's global scale. Associations between RA disease severity and preterm delivery, small for gestational age (SGA), or cesarean delivery were tested in unadjusted and multivariate analyses using modified Poisson regression models.

Results: The sample consisted of 440 women with RA. Several unadjusted comparisons yielded significant associations. After adjustment for covariates, increasing disease severity was associated with risk for preterm delivery and SGA. For each unit increase in HAQ-DI (0-1), the adjusted relative risk (aRR) for preterm delivery increased by 58% (aRR 1.58, 95% CI 1.17-2.15). Among those with HAQ-DI > 0.5, the aRR for SGA was 1.81 (95% CI 1.01-3.33).

Conclusion: RA disease severity in early pregnancy, as measured in this study, was predictive of preterm delivery and SGA. These findings suggest that the risk of preterm delivery and SGA in women with RA might be lowered if RA is well controlled early in pregnancy.

Keywords: DISEASE SEVERITY; PREGNANCY OUTCOMES; RHEUMATOID ARTHRITIS.

PubMed Disclaimer

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- HighWire
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project

Affiliations

Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project

Authors

Affiliations

Abstract

MeSH terms

LinkOut - more resources

Full Text Sources

Medical