Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Berlin, Germany
Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Berlin, Germany.
RMD Open. 2022 Jul;8(2). doi: 10.1136/rmdopen-2021-002146.
To investigate pregnancy outcomes in women with axial spondyloarthritis (axSpA) under different pharmacological treatments in comparison with matched controls.
Using health insurance data from 2006 to 2019, pregnancy outcomes of women with axSpA were compared with those of age-matched and calendar year-matched controls without axSpA. Women with axSpA were further stratified by treatment prior to delivery and pregnancy outcomes compared. Adjusted ORs (aORs) with 95% CIs were calculated using generalised estimating equation analyses.
A total of 1021 pregnancy outcomes in patients with axSpA were identified (928 deliveries, 80 abortions, 13 ectopic pregnancies) and compared with 10 210 pregnancy outcomes in controls (9488 deliveries, 615 abortions, 147 ectopic pregnancies). Compared with controls, women with axSpA showed higher odds of elective caesarean section (aOR 1.52; 1.25 to 1.85).Among women with axSpA, the risk of preterm birth was higher under non-steroidal anti-inflammatory drugs (NSAIDs) treatment (aOR 2.22; 1.09 to 4.52) than without any anti-inflammatory treatment. The risks of preterm birth (aOR 4.01; 1.93 to 8.34) and small-for-gestational-age (aOR 3.22; 1.34 to 7.73) were increased under NSAIDs treatment in combination with conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), steroids or analgesics. Non-significant increased risks of small-for-gestational-age (aOR 1.68; 0.43 to 6.57) and preterm birth (aOR 1.56; 0.51 to 4.83) were found under biological DMARDs.
Women with axSpA have significantly increased odds of caesarean section compared with matched controls. Risks of preterm birth and small-for-gestational-age vary by type of anti-inflammatory treatment.
比较不同药物治疗下中轴型脊柱关节炎（axSpA）女性与匹配对照者的妊娠结局。
利用 2006 年至 2019 年的医疗保险数据，比较 axSpA 女性与无 axSpA 的年龄和年份匹配对照者的妊娠结局。根据分娩前的治疗方法对 axSpA 女性进行分层，并比较妊娠结局。使用广义估计方程分析计算调整后的比值比（aOR）及其 95%置信区间。
共纳入 1021 例 axSpA 患者的妊娠结局（928 例分娩，80 例流产，13 例异位妊娠），并与 10210 例对照者的妊娠结局（9488 例分娩，615 例流产，147 例异位妊娠）进行比较。与对照者相比，axSpA 女性行择期剖宫产的可能性更高（aOR 1.52；1.25 至 1.85）。在 axSpA 女性中，与未接受任何抗炎治疗相比，接受非甾体抗炎药（NSAIDs）治疗者早产风险更高（aOR 2.22；1.09 至 4.52）。接受 NSAIDs 联合常规合成改善病情抗风湿药物（DMARDs）、类固醇或镇痛药治疗者，早产（aOR 4.01；1.93 至 8.34）和小于胎龄儿（aOR 3.22；1.34 至 7.73）的风险增加。生物 DMARDs 治疗下，小于胎龄儿（aOR 1.68；0.43 至 6.57）和早产（aOR 1.56；0.51 至 4.83）的风险无显著增加。
与匹配对照者相比，axSpA 女性行剖宫产的可能性显著增加。早产和小于胎龄儿的风险因抗炎治疗类型而异。
