Giovannopoulou Eirini, Gkasdaris Grigorios, Kapetanakis Stylianos, Kontomanolis Emmanuel
Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis. Greece.
Curr Rheumatol Rev. 2017;13(3):162-169. doi: 10.2174/1573397113666170317114857.
Ankylosing Spondylitis (AS) is the prototype of a group of systemic rheumatic diseases collectively referred to as Spondylarthitides (SpA). It has now become clear that AS is not as rare as previously thought and, although it has an early onset in life affecting patients in their reproductive years, it has not been proved to adversely affect fertility in females.
The aim of this review is to summarize all the recent data on AS and pregnancy in terms of fertility, disease course and pregnancy outcome from a clinical perspective.
A literature research was conducted based on the following medical databases: Pubmed/ Medline and the Cochrane Library. We searched for randomized controlled studies, casecontrol studies, cohort studies, patient and drug registers in relation to pregnancy and AS.
The existing data do not support a causal relationship between AS and infertility. The state of pregnancy is not associated with reduced disease activity in patients with AS. Additionally, AS tends to adversely affect health-related quality of life during pregnancy, in comparison with normal population and patients with rheumatoid arthritis. As far as the obstetrical outcome is concerned, there is no consensus on the significant association between AS and specific pregnancy, delivery and fetal complications.
Previous studies are highly heterogenous and mainly retrospective and thus, the existing data are controversial and inconclusive. Subsequent studies are required to enlighten our knowledge on the interaction between AS and pregnancy.
强直性脊柱炎（AS）是一组统称为脊柱关节炎（SpA）的全身性风湿性疾病的原型。现在已经清楚，AS并不像以前认为的那样罕见，尽管它在生命早期发病，影响处于生育年龄的患者，但尚未证明它会对女性生育能力产生不利影响。
本综述的目的是从临床角度总结关于AS与妊娠在生育能力、疾病进程和妊娠结局方面的所有最新数据。
基于以下医学数据库进行文献研究：PubMed/Medline和Cochrane图书馆。我们搜索了与妊娠和AS相关的随机对照研究、病例对照研究、队列研究、患者和药物登记。
现有数据不支持AS与不孕之间存在因果关系。妊娠状态与AS患者疾病活动度降低无关。此外，与正常人群和类风湿关节炎患者相比，AS往往会对妊娠期间与健康相关的生活质量产生不利影响。就产科结局而言，关于AS与特定妊娠、分娩和胎儿并发症之间的显著关联尚无共识。
先前的研究高度异质性且主要为回顾性研究，因此现有数据存在争议且无定论。需要后续研究来增进我们对AS与妊娠之间相互作用的认识。
