Sonkurt Ali İhsan, Doğan Gül, Parlar Kerem, Güler Berkay, Deveci Müge, Kasapçopur Özgür, Uğurlu Serdal
Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Division of Pediatric Rheumatology, Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Clin Rheumatol. 2025 Feb;44(2):789-797. doi: 10.1007/s10067-025-07308-z. Epub 2025 Jan 13.
To investigate the fertility status, pregnancy outcomes, and disease activity during and after pregnancy in patients with juvenile idiopathic arthritis (JIA) currently being followed up at an adult rheumatology clinic. This study included 141 adult patients diagnosed with according to the International League of Associations for Rheumatology criteria, who are now monitored at an adult rheumatology clinic. Data on demographics, disease characteristics, medication history, fertility status, and pregnancy outcomes were collected through medical records and patient interviews. Statistical analysis was performed using Fisher's exact test to compare categorical variables. Statistical significance was set at p < 0.05. Out of 141 patients (65 male, 76 female), 19 female and 6 male patients attempted to have children. Six male patients fathered ten children without assisted reproductive techniques (ART), while 16 female patients had 19 children. Only one patient couldn't conceive. The observed pregnancy complications included miscarriage (17.4%), preeclampsia (4.3%), preterm birth (4.3%), and gestational diabetes (4.3%). Flares during or within the first month after labor in 32.2% of pregnancies. There was no statistically significant association between medication use and pregnancy complications or disease activity during pregnancy. JIA does not significantly impact fertility or increase the risk of pregnancy complications and adverse pregnancy outcomes. Disease activity during pregnancy and postpartum flares are manageable without the need for additional precautions. Patients with JIA can pursue pregnancy without significant concerns related to their condition. Key Points • JIA does not significantly impact fertility in both male and female patients. • JIA does not increase risk of adverse pregnancy outcomes or complications. • JIA disease activity remains stable and manageable during pregnancy and postpartum.
为调查目前在成人风湿病诊所接受随访的幼年特发性关节炎(JIA)患者的生育状况、妊娠结局以及孕期和产后的疾病活动情况。本研究纳入了141例根据国际风湿病联盟标准确诊的成年患者,他们目前在成人风湿病诊所接受监测。通过病历和患者访谈收集了人口统计学、疾病特征、用药史、生育状况和妊娠结局的数据。采用Fisher精确检验进行统计分析以比较分类变量。设定统计学显著性为p < 0.05。在141例患者(65例男性,76例女性)中,19例女性和6例男性患者尝试生育。6例男性患者在未采用辅助生殖技术(ART)的情况下育有10个孩子,而16例女性患者育有19个孩子。只有1例患者未能受孕。观察到的妊娠并发症包括流产(17.4%)、子痫前期(4.3%)、早产(4.3%)和妊娠期糖尿病(4.3%)。32.2%的妊娠在分娩期间或分娩后第一个月内出现病情复发。用药与妊娠并发症或孕期疾病活动之间无统计学显著关联。JIA不会显著影响生育能力,也不会增加妊娠并发症和不良妊娠结局的风险。孕期和产后病情复发的疾病活动是可控的,无需额外的预防措施。JIA患者可以放心地追求妊娠,而无需过多担心其病情。要点 • JIA对男性和女性患者的生育能力均无显著影响。 • JIA不会增加不良妊娠结局或并发症的风险。 • JIA在孕期和产后的疾病活动保持稳定且可控。