Adverse pregnancy outcomes and risk of subsequent rheumatoid arthritis.
Autor: | Ma KK; University of Washington, Seattle., Nelson JL, Guthrie KA, Dugowson CE, Gammill HS |
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Jazyk: | angličtina |
Zdroj: | Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2014 Mar; Vol. 66 (3), pp. 508-12. |
DOI: | 10.1002/art.38247 |
Abstrakt: | Objective: Pregnancy and reproductive outcomes have been associated with altered risk of some autoimmune diseases, including rheumatoid arthritis (RA). We sought to determine whether prior pregnancy resulting in a low birth weight (LBW) infant or preterm birth is associated with a risk of subsequent RA in the mother. Methods: We conducted an analysis of RA risk in parous women from a population-based prospective study of newly diagnosed cases of RA and age-matched healthy controls. The primary outcome measure was disease status (RA versus control), with exposures of prior preterm birth and prior delivery of an infant with LBW (≤2,500 gm), very low birth weight (VLBW; ≤1,500 gm), or extremely low birth weight (ELBW; ≤1,000 gm). A preplanned analysis including only rheumatoid factor (RF)-positive RA cases was also conducted. Results: A total of 202 RA cases and 1,102 controls were analyzed. Prior delivery of an infant with ELBW was associated with RA in the mother (relative risk [RR] 3.7 [95% confidence interval (95% CI) 1.0-13.2]). Prior VLBW (RR 4.0 [95% CI 1.3-11.4]) and ELBW (RR 5.5 [95% CI 1.4-22.5]) infants were associated with RF-positive RA. Prior LBW deliveries and preterm births were more common among RA cases than controls, but the differences were not statistically significant. Conclusion: Compared to those with uncomplicated pregnancies, women with a prior VLBW or ELBW delivery had a higher risk of RA, particularly RF-positive RA. This association may reflect common risk factors for pregnancy complications and RA. Alternatively, complicated pregnancy itself may confer risk of subsequent RA. (Copyright © 2014 by the American College of Rheumatology.) |
Databáze: | MEDLINE |
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