Ziegler Caroline I, Recker Florian, Behning Charlotte, Mielczarek Pia, Strizek Brigitte, Petzinna Simon M, Schäfer Valentin S
Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
Arch Gynecol Obstet. 2025 Jul 9. doi: 10.1007/s00404-025-08107-2.
This prospective observational, hypothesis-generating study aims to investigate the impact of pregnancy on disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) using musculoskeletal ultrasound (MSUS) and to explore the potential of MSUS to enhance disease monitoring during pregnancy.
The study enrolled female participants divided into four groups: pregnant women with RA or PsA, non-pregnant women with RA or PsA, healthy pregnant women, and healthy non-pregnant women. Disease activity was assessed using the Rheumatoid Arthritis Impact of Disease (RAID) score and the Psoriatic Arthritis Impact of Disease (PsAID) score, as well as self-reported questionnaires on health perception. MSUS was performed using the Butterfly iQ portable ultrasound scanner, with synovial hypertrophy and joint effusion assessed via the Advanced Sonography of Large Joints in Rheumatology (aSOLAR) score.
A total of 105 participants were included: 15 pregnant women with RA or PsA, 30 non-pregnant women with RA or PsA, 30 healthy pregnant women, and 30 healthy non-pregnant women. In pregnant women with RA, conventional disease activity scores and the aSOLAR score showed lower values over the course of pregnancy. In contrast, non-pregnant RA patients generally presented with higher scores in both conventional assessments and the aSOLAR score. Among pregnant PsA patients, conventional scores appeared lower over time, while the aSOLAR score showed comparatively higher values in later pregnancy. Self-reported health perception was more favorable in pregnant RA and PsA patients than in their non-pregnant counterparts. The CRP levels tended to be lower in later pregnancy phases among both RA and PsA patients.
This pioneering study demonstrates the potential impact of pregnancy on the disease activity of RA and PsA. It emphasizes the exploratory potential of MSUS as an imaging biomarker in the assessment of these conditions during pregnancy. The observed discrepancies between conventional, self-reported diagnostic tools and ultrasound findings support the hypothesis that objective imaging modalities may improve disease monitoring. Our findings warrant further validation in larger, confirmatory studies.
这项前瞻性观察性、产生假设的研究旨在利用肌肉骨骼超声（MSUS）研究妊娠对类风湿关节炎（RA）和银屑病关节炎（PsA）疾病活动的影响，并探索MSUS在加强妊娠期间疾病监测方面的潜力。
该研究招募了女性参与者，分为四组：患有RA或PsA的孕妇、患有RA或PsA的非孕妇、健康孕妇和健康非孕妇。使用类风湿关节炎疾病影响（RAID）评分和银屑病关节炎疾病影响（PsAID）评分以及关于健康认知的自我报告问卷来评估疾病活动。使用Butterfly iQ便携式超声扫描仪进行MSUS检查，通过风湿病大关节高级超声检查（aSOLAR）评分评估滑膜增生和关节积液。
总共纳入了105名参与者：15名患有RA或PsA的孕妇、30名患有RA或PsA的非孕妇、30名健康孕妇和30名健康非孕妇。在患有RA的孕妇中，传统疾病活动评分和aSOLAR评分在妊娠过程中显示出较低的值。相比之下,非妊娠RA患者在传统评估和aSOLAR评分中通常得分较高。在患有PsA的孕妇中，传统评分随时间推移似乎较低，而aSOLAR评分在妊娠后期显示出相对较高的值。患有RA和PsA的孕妇自我报告的健康认知比未怀孕的对应者更有利。RA和PsA患者在妊娠后期CRP水平往往较低。
这项开创性研究证明了妊娠对RA和PsA疾病活动的潜在影响。它强调了MSUS作为一种成像生物标志物在评估妊娠期间这些情况方面的探索潜力。传统的、自我报告的诊断工具与超声检查结果之间观察到的差异支持了客观成像方式可能改善疾病监测的假设。我们的研究结果需要在更大规模的验证性研究中进一步验证。
