Park Jin-Su, Chung Min Kyung, Lim Hyunsun, Lee Jisoo, Lee Chan Hee
Division of Rheumatology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Division of Rheumatology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2022 Jan 10;37(2):e18. doi: 10.3346/jkms.2022.37.e18.
To determine the risk of pregnancy complications and adverse offspring outcomes in Korean women with rheumatic diseases (RDs).
Women aged 20-44 years with pregnancies ending in delivery were identified from the National Health Insurance Service-National Health Information Database (2009-2016). Women with RD including systemic lupus erythematosus (SLE), seropositive rheumatoid arthritis (SPRA), and ankylosing spondylitis (AS) (n = 4,284) were age-matched with controls (n = 26,023). Outcome variables included threatened abortion (TA), preterm birth (PB), preeclampsia/eclampsia (PE/E), intrauterine growth retardation (IGR), urinary tract infection, low birth weight (LBW) offsprings, and offspring death within 1 year of birth.
Women with RDs had increased risks for cesarean section delivery (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.4-1.6), TA (OR, 1.4; 95% CI, 1.2-1.5), PB (OR, 2.4; 95% CI, 1.9-3.2), PE/E (OR, 4.4; 95% CI, 3.3-5.9), and IGR (OR, 2.4; 95% CI, 2.0-3.1) than the controls. The risk of pregnancy complications was increased in SLE and SPRA pregnancies but not in AS pregnancies. Offsprings of women with RDs had an increased risk of LBW (OR, 4.0; 95% CI, 3.2-4.9). The offspring mortality rate within 1 year of birth was higher in women with RDs (6.2/10,000 persons) than in the controls (4.9/10,000 persons).
Women with RDs are at a risk of developing pregnancy complications, and the risk of LBW offsprings and offspring death within 1 year of birth is increased in these women. Therefore, this population requires special attention during their childbearing years.
确定患有风湿性疾病（RDs）的韩国女性发生妊娠并发症及不良子代结局的风险。
从国家健康保险服务 - 国家健康信息数据库（2009 - 2016年）中识别出年龄在20 - 44岁且妊娠以分娩结束的女性。患有包括系统性红斑狼疮（SLE）、血清反应阳性类风湿关节炎（SPRA）和强直性脊柱炎（AS）在内的RDs的女性（n = 4284）与对照组（n = 26023）进行年龄匹配。结局变量包括先兆流产（TA）、早产（PB）、子痫前期/子痫（PE/E）、胎儿生长受限（IGR）、尿路感染、低出生体重（LBW）子代以及出生后1年内子代死亡。
与对照组相比，患有RDs的女性剖宫产分娩风险增加（比值比[OR]，1.5；95%置信区间[CI]，1.4 - 1.6），TA风险增加（OR，1.4；95% CI，1.2 - 1.5），PB风险增加（OR，2.4；95% CI，1.9 - 3.2），PE/E风险增加（OR，4.4；95% CI，3.3 - 5.9），IGR风险增加（OR，2.4；95% CI，2.0 - 3.1）。SLE和SPRA妊娠中妊娠并发症风险增加，但AS妊娠中未增加。患有RDs的女性的子代LBW风险增加（OR，4.0；95% CI，3.2 - 4.9）。患有RDs的女性出生后1年内的子代死亡率（6.2/10000人）高于对照组（4.9/10000人）。
患有RDs的女性有发生妊娠并发症的风险，且这些女性所生低出生体重子代及出生后1年内子代死亡的风险增加。因此，该人群在生育年龄需要特别关注。
