Jawaheer Damini, Zhu Jin Liang, Nohr Ellen A, Olsen Jørn
Children's Hospital Oakland Research Institute, Oakland, California 94609, USA.
Arthritis Rheum. 2011 Jun;63(6):1517-21. doi: 10.1002/art.30327.
To assess whether onset of rheumatoid arthritis (RA) prior to conception is associated with a delayed time to pregnancy (TTP).
The study included pregnant women from across Denmark who enrolled in the Danish National Birth Cohort between 1996 and 2002 and had planned or partly planned the cohort pregnancy. RA diagnosis was identified using the Danish National Hospital Discharge Registry. Self-reported data, including TTP, maternal age, parity, prepregnancy height and weight, maternal occupational status, smoking, and alcohol consumption, were collected using a detailed computer-assisted telephone interview at ∼16 weeks of gestation. We used logistic regression analyses as well as a complementary log regression model to examine whether TTP was influenced by RA, adjusting for the abovementioned variables.
Overall, compared with women with no recorded RA (n=74,255), women with prevalent RA (onset prior to conception) (n=112) were slightly older (mean±SD age 30.8±4.3 years versus 29.7±4.1 years), were more likely to have been treated for infertility (9.8% versus 7.6%), and were more likely to have taken>12 months to conceive (25.0% versus 15.6%). The association between RA and TTP was borderline significant after adjusting for covariates in the regression analyses (odds ratio 1.6 [95% confidence interval 1.0-2.4]). Similar results were obtained after restricting the analyses to women who had planned the pregnancy or those who were nulliparous before the cohort pregnancy.
Women with RA onset prior to conception had a slightly longer TTP compared with those who did not have RA, indicating a slight reduction in fecundity.
评估受孕前类风湿关节炎(RA)的发病是否与受孕时间延迟(TTP)相关。
该研究纳入了1996年至2002年间登记参加丹麦国家出生队列且已计划或部分计划队列妊娠的丹麦各地孕妇。使用丹麦国家医院出院登记处的数据确定RA诊断。在妊娠约16周时,通过详细的计算机辅助电话访谈收集自我报告的数据,包括TTP、产妇年龄、产次、孕前身高和体重、产妇职业状况、吸烟和饮酒情况。我们使用逻辑回归分析以及互补对数回归模型来检验TTP是否受RA影响,并对上述变量进行了调整。
总体而言,与无RA记录的女性(n = 74,255)相比,患有现患RA(受孕前发病)的女性(n = 112)年龄稍大(平均±标准差年龄为30.8±4.3岁,而无RA记录的女性为29.7±4.1岁),更有可能接受过不孕症治疗(9.8%对7.6%),且更有可能需要超过12个月才能受孕(25.0%对15.6%)。在回归分析中对协变量进行调整后,RA与TTP之间的关联接近显著(比值比1.6 [95%置信区间1.0 - 2.4])。将分析限制在计划妊娠的女性或队列妊娠前未生育的女性中,也得到了类似的结果。
受孕前发病的RA女性与未患RA的女性相比,TTP略长,表明生育力略有下降。