Autoimmune Diseases Such as Rheumatoid Arthritis Could Be An Indicator For Preterm Birth

Autoimmune Diseases Such as Rheumatoid Arthritis Could Be An Indicator For Preterm Birth

Analysis of pregnant women’s health and their subsequent effects on fetal health was recently performed on data obtained by the Organization of Teratology Information Specialists (OTIS), a North American university and hospital-based network of telephone-based teratogen counseling services across the United States and Canada. The Autoimmune Diseases in Pregnancy Project included data that was self reported by women, both with and without an autoimmune disease. The parameters included an assessment of Health Assessment Questionnaire – Disability Index (HAQ-DI), Pain Score (PS) and Patient’s Global Scale (PGS) in order to judge the severity of the disease.

The reporting population included a total of 440 mothers who were diagnosed with Rheumatoid Arthritis (RA), interviewed 20 weeks prior to gestation (the second trimester of pregnancy) and 2 to 4 weeks after delivery as well. Verification of medical records showed an accuracy of 95% in the data assessed.

Preterm (premature) delivery was defined as delivery before the allotted 37 weeks of pregnancy, and small for gestational age (SGA) was defined as a newborn baby weight lower than or equal to the 10th percentile.

The results showed that around 15% of the women had preterm deliveries, 9% had babies with SGA and 42% had c-section deliveries.  It was suggested that patients who had a history of auto-immune diseases, were older in age, had another preterm delivery previously, and had been living on a dosage of 10mg of Prednisone (an immunosuppressive corticosteroid). On the other hand, pregnant women who gave birth to underweight children (SGA) were concluded to have been affected with Crohn’s Disease and had been living on a dosage of more than 10mg of Prednisone. Older women mostly had c-section deliveries.

Statistical analysis of the same showed that HAQ-DI and PGS were significantly related to preterm deliveries, and that chances (risks) of preterm delivery were increased by 58% with every unit increase in HAQ-DI score. Also, Prednisone usage of more than 10mg was an independent predictor of this.

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