Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
J Intern Med. 2010 Oct;268(4):329-37. doi: 10.1111/j.1365-2796.2010.02239.x.
To examine the prevalence of preterm birth, infants with low Apgar score, small for gestational age (SGA) birth, stillbirth and congenital abnormalities in women with rheumatoid arthritis (RA) compared with women without RA.
Prevalence study.
Combined Sweden and Denmark nationwide from 1994 to 2006.
We included 871,579 women with a first-time singleton birth identified through population-based healthcare databases.
We compared the prevalence of preterm birth, low Apgar score (<7 at 5 min), SGA birth, stillbirth and congenital abnormalities amongst women with RA compared with women without RA using prevalence odds ratio (OR) with 95% confidence interval (95% CI), whilst controlling for maternal age, smoking, parental cohabitation and year. We stratified analyses by period of birth (1994-1997, 1998-2001 and 2002-2006).
Amongst 1199 women with RA, 7.8% gave birth between 32 and 36 gestational weeks (adjusted OR, 1.44; 95% CI, 1.14-1.82), 1.4% gave birth before gestational week 32 (adjusted OR, 1.55; 95% CI, 0.97-2.47), 1.6% had an infant with a low Apgar score (OR, 0.99; 95% CI, 0.95-1.65), 5.9% had an SGA birth (adjusted OR, 1.56; 95% CI, 1.2-2.01), 0.9% experienced stillbirth (adjusted OR, 2.07; 95% CI, 0.98-4.35) and 4.3% gave birth to an infant with congenital abnormalities (adjusted OR,1.32; 95% CI, 0.98-1.79). The OR for congenital abnormalities decreased from 2.57 (95% CI, 1.59-4.16) in 1994-1997 to 1.00 (95% CI, 0.64-1.56) in 2002-2006.
Women with RA had a high prevalence of most adverse birth outcomes. This could be due to inflammatory activity, medical treatment or other factors not controlled for.
比较类风湿关节炎（RA）女性与非 RA 女性的早产、低 Apgar 评分、小于胎龄儿（SGA）、死产和先天性异常的发生率。
患病率研究。
1994 年至 2006 年瑞典和丹麦全国范围的综合人群。
我们纳入了 871579 名通过基于人群的医疗保健数据库首次分娩的单胎女性。
我们使用优势比（OR）及其 95%置信区间（95%CI）比较了 RA 女性与非 RA 女性的早产、5 分钟 Apgar 评分<7 分、SGA 分娩、死产和先天性异常的发生率，同时控制了母亲年龄、吸烟、父母同居和年份。我们根据分娩期（1994-1997 年、1998-2001 年和 2002-2006 年）进行分层分析。
在 1199 名 RA 女性中，有 7.8%的女性在 32 至 36 孕周分娩（校正 OR，1.44；95%CI，1.14-1.82），1.4%的女性在 32 孕周前分娩（校正 OR，1.55；95%CI，0.97-2.47），1.6%的新生儿 Apgar 评分低（OR，0.99；95%CI，0.95-1.65），5.9%的新生儿 SGA（校正 OR，1.56；95%CI，1.2-2.01），0.9%的死产（校正 OR，2.07；95%CI，0.98-4.35），4.3%的新生儿有先天性异常（校正 OR，1.32；95%CI，0.98-1.79）。1994-1997 年先天性异常的 OR 为 2.57（95%CI，1.59-4.16），2002-2006 年降至 1.00（95%CI，0.64-1.56）。
RA 女性的大多数不良分娩结局发生率较高。这可能是由于炎症活动、药物治疗或其他未控制的因素所致。
