Rheumatoid arthritis has similar rates of postpartum maternal outcomes


The impact of rheumatoid arthritis (RA) on postpartum maternal outcomes was poorly understood. Researchers assessed postpartum maternal outcomes in RA using a cohort of real-life electronic health records (EHRs). Using an ICD-9 or ICD-10-CM code greater than or equal to 1 delivery and a proven RA algorithm, they detected likely RA deliveries in a large anonymized EHR. When reviewing records, cases of RA should be diagnosed by a rheumatologist. Blood transfusion rates, infection rates up to 6 weeks postpartum as assessed by a physician, and length of hospital stay were among maternal outcomes postpartum. Investigators also found pregnancies in women who did not have autoimmune disorders. They found 202 deliveries after a diagnosis of RA and 596 deliveries in people who did not have autoimmune disorders. Postpartum infection rate (8% versus 4%, p=0.10) and red blood cell transfusion rate (2% vs 2%, p=1.00) were similar in RA patients and controls. Postpartum infection was not significantly related to RA case status (OR = 2.10, 95% CI 0.88 – 4.98, p=0.09), while prematurity was (OR=2.11, 95% CI 1.38, 3.23, p=0.001). Corticosteroids were used by 41% of pregnant women, while tumor necrosis factor inhibitors were used by 13%. Corticosteroid use at delivery was unrelated to maternal postpartum infections after correcting for age at delivery and race; however, it was associated with significantly lower birth weight in RA patients. Women with RA have a higher risk of adverse pregnancy outcomes, particularly preterm delivery. However, research has shown that in patients with rheumatoid arthritis, postpartum maternal outcomes such as postpartum infection and blood transfusion are not significantly elevated.



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