Barrett J H, Brennan P, Fiddler M, Silman A J
Arthritis Research Campaign Epidemiology Unit, University of Manchester, UK.
Arthritis Rheum. 1999 Jun;42(6):1219-27. doi: 10.1002/1529-0131(199906)42:6<1219::AID-ANR19>3.0.CO;2-G.
To ascertain the influence of pregnancy on disease activity in women with rheumatoid arthritis (RA) during pregnancy and postpartum.
One hundred forty pregnant women were recruited from a nationwide campaign and were followed prospectively in the last trimester and at 1 and 6 months postpartum. Standardized assessment of joint symptoms, examination of inflamed joints, and the Health Assessment Questionnaire (HAQ) were the main measures of disease activity.
There was only a modest fall in HAQ scores during pregnancy, with >25% of women having substantial levels of disability. Other parameters of disease activity showed a greater trend toward improvement, although only 23 (16%) were in complete remission (no joints with active disease and no therapy). Similarly, there was relatively little change in the distribution of HAQ scores from pregnancy to postpartum. There was, however, a statistically significant increase in the mean number of inflamed joints compared with the findings during pregnancy. Analysis of the possible influence of treatment suggested that therapy was associated with more severe disease and was not related to reduction in disease activity.
This, the largest prospective study of the influence of pregnancy on RA activity, has demonstrated widespread variability in disease response.
确定妊娠对类风湿关节炎（RA）女性患者孕期及产后疾病活动度的影响。
从一项全国性活动中招募了140名孕妇，并在妊娠晚期、产后1个月和6个月进行前瞻性随访。关节症状的标准化评估、炎症关节检查以及健康评估问卷（HAQ）是疾病活动度的主要测量指标。
孕期HAQ评分仅略有下降，超过25%的女性有严重残疾水平。疾病活动度的其他参数显示出更大的改善趋势，尽管只有23名（16%）完全缓解（无活动性疾病关节且未接受治疗）。同样，从孕期到产后，HAQ评分分布变化相对较小。然而，与孕期相比，炎症关节的平均数量有统计学意义的增加。对治疗可能影响的分析表明，治疗与更严重的疾病相关，与疾病活动度降低无关。
这项关于妊娠对RA活动度影响的最大规模前瞻性研究表明，疾病反应存在广泛差异。
