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. 2022 Sep 17;22(1):1768.
doi: 10.1186/s12889-022-14163-z.

Pregnancy loss and the risk of rheumatoid arthritis in Chinese women: findings from the China Kadoorie biobank

Jia Yi Hee #  1 , Sha Huang #  1 , Khai Pang Leong  2 , Li Chun  3 , Yuxun Oswald Zhang  1 , Ruofan Gongye  4 , Kun Tang  5
Affiliations

Pregnancy loss and the risk of rheumatoid arthritis in Chinese women: findings from the China Kadoorie biobank

Jia Yi Hee et al. BMC Public Health. .

Abstract

Considering the female preponderance of rheumatoid arthritis (RA), and disease onset typically after the reproductive years, pregnancy and childbirth may play a role in the aetiology of the disease. Adverse outcomes of pregnancy have been found to precede the diagnosis of autoimmune diseases, including RA, but the evidence is scant and inconsistent. Therefore, we investigate whether pregnancy loss is associated with the risk of RA in Chinese women. Data from the China Kadoorie Biobank, conducted by the University of Oxford and the Chinese Centre for Disease Control and Prevention, of 299,629 Chinese women who had been pregnant were used. Multivariable logistic regression and stratified analyses were employed to analyse the association between types of pregnancy loss with the risk of RA. Pregnancy loss was significantly associated with increased risk of RA (OR 1.12, 95% CI 1.06-1.18), specifically, spontaneous (OR 1.11, 95% CI 1.03-1.20) and induced abortions (OR 1.11, 95% CI 1.06-1.17). There was no significant association between stillbirth and the risk of RA (OR 1.07, 95% CI 0.97-1.18). The risk of developing RA increases with the number of pregnancy losses: one loss confers an OR of 1.09 (95% CI 1.03-1.16), two an OR of 1.13 (95% CI 1.05-1.20), three or more an OR of 1.19 (95% CI 1.10-1.28) and OR of 1.06 (95% CI 1.03-1.08) for each additional. Spontaneous and induced abortions are associated with an increased risk of RA in Chinese women.

Keywords: China Kadoorie biobank; Induced abortion; Pregnancy loss; Rheumatoid arthritis; Spontaneous abortion; Stillbirth.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
Flow diagram of inclusion or exclusion of study participants
Fig. 2
Fig. 2
Effect estimates of the association between pregnancy loss and rheumatoid arthritis risk. Adjustments are as in Table 2 model 2
Fig. 3
Fig. 3
Stratified effect estimates of the association between pregnancy loss (ever vs. never) and rheumatoid arthritis risk. Adjustments are as in Table 3
See this image and copyright information in PMC

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