Clinical Report: Rheumatoid arthritis tied to birth outcomes
Overview
Pregnancies among patients with rheumatoid arthritis (RA) are linked to increased rates of preterm birth and small-for-gestational-age infants compared to the general population. A multicenter study found preterm birth rates of 16% in RA pregnancies versus 8% in controls, and small-for-gestational-age rates of 21% versus 11%, respectively.
Background
Rheumatoid arthritis is a chronic inflammatory disorder that can complicate pregnancy, leading to adverse outcomes. This study provides data on the prevalence of preterm birth and small-for-gestational-age infants in this population.
Data Highlights
| Outcome | RA Pregnancies (%) | Control Pregnancies (%) |
|---|---|---|
| Preterm Birth | 16 | 8 |
| Small-for-Gestational-Age (<10th percentile) | 21 | 11 |
| Small-for-Gestational-Age (<3rd percentile) | 6 | 2 |
Key Findings
- Preterm birth occurred in 16% of RA pregnancies compared to 8% in controls.
- 21% of RA pregnancies resulted in small-for-gestational-age infants (<10th percentile) versus 11% in controls.
- Nulliparity was associated with small-for-gestational-age births.
- Maternal age and glucocorticoid exposure at doses ≥10 mg/day were linked to increased odds of preterm birth.
- Moderate or high RA activity was documented in 27% of pregnancies with available disease-activity measurements.
- No significant differences were found in gestational diabetes, cesarean delivery, or congenital malformations between the groups.
Clinical Implications
Clinicians should be aware of the increased risks of preterm birth and small-for-gestational-age infants in pregnancies affected by rheumatoid arthritis. Monitoring disease activity and medication exposure during pregnancy is essential for optimizing maternal and fetal outcomes.
Conclusion
The study highlights the elevated risks associated with pregnancies in patients with rheumatoid arthritis, emphasizing the need for careful management and monitoring during this vulnerable period.
Related Resources & Content
- Evaluation of pregnancy outcomes in patients with rheumatoid arthritis compared with the general population: results from a French national prospective and matched study, RMD Open, 2026 -- Rheumatoid arthritis tied to birth outcomes
- EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update, PubMed -- EULAR recommendations
- The Asia Pacific League of Associations for Rheumatology (APLAR) Consensus Statements for the Management of Reproductive Issues in Autoimmune Rheumatic Diseases, PMC -- APLAR Consensus Statements
- Arthritis Care & Research — Real-World Trends in Prenatal Antirheumatic Drug Utilization in Ontario, Canada: A Cross-Sectional Time-Series Analysis
- MDSpire News — Childhood Maltreatment Linked to Rheumatoid Arthritis Risk
- MDSpire News — Effect of Rheumatic and Immune-Mediated Diseases on Reproductive Health
- MDSpire News — Reproductive Health Framework for Care
- Real-World Trends in Prenatal Antirheumatic Drug Utilization in Ontario, Canada: A Cross-Sectional Time-Series Analysis
- Childhood Maltreatment Linked to Rheumatoid Arthritis Risk
- Effect of Rheumatic and Immune-Mediated Diseases on Reproductive Health
- Evaluation of pregnancy outcomes in patients with rheumatoid arthritis compared with the general population: results from a French national prospective and matched study | RMD Open
- EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update - PubMed
- The Asia Pacific League of Associations for Rheumatology (APLAR) Consensus Statements for the Management of Reproductive Issues in Autoimmune Rheumatic Diseases - PMC
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