Pregnancy and neonatal outcomes in women with axial spondyloarthritis: pooled data analysis from the European Network of Pregnancy Registries in Rheumatology (EuNeP)
Standard
Pregnancy and neonatal outcomes in women with axial spondyloarthritis: pooled data analysis from the European Network of Pregnancy Registries in Rheumatology (EuNeP). / Meissner, Yvette; Strangfeld, Anja; Molto, Anna; Forger, Frauke; Wallenius, Marianne; Costedoat-Chalumeau, Nathalie; Bjørngaard, Hilde; Couderc, Marion; Flipo, René-Marc; Guettrot-Imbert, Gaëlle; Haase, Isabell; Jakobsen, Bente; Koksvik, Hege Suorza Svean; Richez, Christophe; Sellam, Jérémie; Weiß, Anja; Zbinden, Astrid; Fischer-Betz, Rebecca; EuNeP collaborator group.
In: ANN RHEUM DIS, Vol. 81, No. 11, 11.2022, p. 1524-1533.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Pregnancy and neonatal outcomes in women with axial spondyloarthritis: pooled data analysis from the European Network of Pregnancy Registries in Rheumatology (EuNeP)
AU - Meissner, Yvette
AU - Strangfeld, Anja
AU - Molto, Anna
AU - Forger, Frauke
AU - Wallenius, Marianne
AU - Costedoat-Chalumeau, Nathalie
AU - Bjørngaard, Hilde
AU - Couderc, Marion
AU - Flipo, René-Marc
AU - Guettrot-Imbert, Gaëlle
AU - Haase, Isabell
AU - Jakobsen, Bente
AU - Koksvik, Hege Suorza Svean
AU - Richez, Christophe
AU - Sellam, Jérémie
AU - Weiß, Anja
AU - Zbinden, Astrid
AU - Fischer-Betz, Rebecca
AU - EuNeP collaborator group
N1 - © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/11
Y1 - 2022/11
N2 - OBJECTIVE: To investigate outcome and course of pregnancies in women with axial spondyloarthritis (axSpA) in a pooled data analysis of pregnancy registries in rheumatology.METHODS: Prospectively followed women with axSpA, fulfilling ASAS classification criteria and for whom a pregnancy outcome was reported, were eligible for the analysis. Anonymised data of four registries was pooled. Rates of adverse pregnancy outcomes were calculated. Systemic inflammation, disease activity and treatment patterns with tumour necrosis factor inhibitor (TNFi) before, during and after pregnancy were analysed.RESULTS: In a total of 332 pregnancies from 304 axSpA women, 98.8% of the pregnancies resulted in live birth. Mean maternal age was 31 years and disease duration 5 years. Most of these patients received pre-conception counselling (78.4%). Before pregnancy, 53% received TNFi treatment, 27.5% in first and 21.4% in third trimester. Pregnancy and neonatal outcomes were favourable with rates of 2.2% for pre-eclampsia, 4.9% for preterm birth, 3.1% for low birth weight and 9.5% for small for gestational age. Neonates were delivered by caesarean section in 27.7% of pregnancies, of which 47.4% were emergencies. Pooled mean CRP was 4 mg/L before conception peaking in the second trimester at 9.4 mg/L. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was below 4 at all time-points.CONCLUSIONS: Pooled rates of most outcomes were better than what had been reported in the literature and within expected rates of those reported for the general population. Pre-conception counselling, planned pregnancies and a tight management in expert centres applying a tailored treatment approach may have contributed to the favourable pregnancy outcomes.
AB - OBJECTIVE: To investigate outcome and course of pregnancies in women with axial spondyloarthritis (axSpA) in a pooled data analysis of pregnancy registries in rheumatology.METHODS: Prospectively followed women with axSpA, fulfilling ASAS classification criteria and for whom a pregnancy outcome was reported, were eligible for the analysis. Anonymised data of four registries was pooled. Rates of adverse pregnancy outcomes were calculated. Systemic inflammation, disease activity and treatment patterns with tumour necrosis factor inhibitor (TNFi) before, during and after pregnancy were analysed.RESULTS: In a total of 332 pregnancies from 304 axSpA women, 98.8% of the pregnancies resulted in live birth. Mean maternal age was 31 years and disease duration 5 years. Most of these patients received pre-conception counselling (78.4%). Before pregnancy, 53% received TNFi treatment, 27.5% in first and 21.4% in third trimester. Pregnancy and neonatal outcomes were favourable with rates of 2.2% for pre-eclampsia, 4.9% for preterm birth, 3.1% for low birth weight and 9.5% for small for gestational age. Neonates were delivered by caesarean section in 27.7% of pregnancies, of which 47.4% were emergencies. Pooled mean CRP was 4 mg/L before conception peaking in the second trimester at 9.4 mg/L. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was below 4 at all time-points.CONCLUSIONS: Pooled rates of most outcomes were better than what had been reported in the literature and within expected rates of those reported for the general population. Pre-conception counselling, planned pregnancies and a tight management in expert centres applying a tailored treatment approach may have contributed to the favourable pregnancy outcomes.
KW - Adult
KW - Axial Spondyloarthritis
KW - Cesarean Section
KW - Data Analysis
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Pregnancy
KW - Premature Birth/epidemiology
KW - Registries
KW - Rheumatology
KW - Severity of Illness Index
KW - Spondylarthritis/drug therapy
KW - Spondylitis, Ankylosing
KW - Treatment Outcome
KW - Tumor Necrosis Factor Inhibitors
KW - Tumor Necrosis Factor-alpha
U2 - 10.1136/ard-2022-222641
DO - 10.1136/ard-2022-222641
M3 - SCORING: Journal article
C2 - 35961759
VL - 81
SP - 1524
EP - 1533
JO - ANN RHEUM DIS
JF - ANN RHEUM DIS
SN - 0003-4967
IS - 11
ER -
