Pregnancy Outcomes in Women with Rheumatoid Arthritis: A Retrospective Population-Based Cohort Study [7N]

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Rheumatoid arthritis (RA) is a chronic autoimmune, inflammatory disease that is more commonly found in women. Our objective is to assess if pregnancies in women with RA are at a higher risk of adverse maternal and neonatal outcomes.


We carried out a retrospective cohort study, using the US Healthcare Cost and Utilization Project National Inpatient Sample from 2004-2013. All births were identified and women were classified as having RA or not on the basis of ICD-9 coding. Logistic regression was used to evaluate the adjusted effect of RA on maternal and neonatal outcomes.


Of the total 8,417,607 births in our cohort, 6,068 were among women with RA. There was a steady increase in RA in pregnancy from 47 to 100/100,000 over the 10-year study period. Compared with women without RA, women with RA were more likely to experience pre-eclampsia/eclampsia (OR 1.70, 95% CI 1.54-1.89), gestational diabetes (OR 1.13, 95% CI 1.02-1.24), PPROM (OR 1.78, 95% CI 1.66-1.91), placental abruption (OR 1.43, 95% CI 1.16-1.76), placenta previa (OR 1.37, 95% CI 1.05-1.78), and to deliver by cesarean section (OR 1.38, 95% CI 1.31-1.45). Congenital anomalies (OR 2.11, 95% CI 1.65-2.72), small for gestational age (OR 2.36, 95% CI 2.09-2.66) and preterm birth (OR 1.81, 95% CI 1.67-1.95) were more common in neonates of women with RA.


RA in pregnancy is associated with greater likelihood of adverse maternal and neonatal outcomes. Women with RA should be made aware of these risks and be followed as a high risk pregnancy.

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