Maternal juvenile rheumatoid arthritis may be associated with preterm birth but not poor fetal growth

ABSTRACT OBJECTIVE: Adverse pregnancy outcomes in mothers with juvenile rheumatoid arthritis (JRA) are not known. The objective of this study was to examine the risk of preterm birth and

restricted fetal growth in pregnant mothers diagnosed with JRA, and to examine the impact of race/ethnicity and maternal age on this association. STUDY DESIGN: Hospital discharge records for

mothers who gave birth in 2011 and 2012 were examined in the National Inpatient Sample (NIS) database. JRA, preterm birth (<37 weeks of gestation), birth weight that is small for

gestational age (SGA) and other demographic and clinical variables were identified using ICD-9 (International Classification of Disease—9th revision) diagnostic codes. The associations of

JRA with preterm birth and restricted fetal growth were examined controlling for confounding variables. RESULT: The sample included 8 273 987 birthing mothers, of these 1236 (0.01%) had JRA.

The prevalence of preterm birth and SGA was 6.08% and 2.34%, respectively. Preterm birth in mothers with JRA was 12.9% compared with 6.1% in mothers without JRA with an adjusted odds ratio

(OR) of 2.1 (confidence interval (CI): 1.74 to 2.42, _P_<0.001). The incidence of SGA in infants born to mothers with JRA was 3.34% compared with 2.34% in non-JRA mothers, which was not

statistically significant. Adjusted OR for preterm birth in association with JRA among White mothers was 1.78 (CI: 1.41 to 2.24, _P_<0.001). However, Hispanic mothers with JRA (12%) were

the ethnicity to suffer the most from preterm birth with an adjusted OR of 4.43 (CI: 2.97 to 6.62, _P_<0.001). Preterm birth among advanced maternal age (AMA) mothers with JRA was 25%

compared with 7% in those without JRA with an adjusted OR of 5.42 (CI: 3.51 to 8.35, _P_<0.001). CONCLUSION: JRA is associated with preterm birth but not with SGA. This association is

significantly influenced by race/ethnicity and maternal age. More studies are needed to examine these findings in relation to medications used, severity of the disease and exacerbation

during pregnancy to understand the genetic/socioeconomic factors behind these racial/ethnic differences. Access through your institution Buy or subscribe This is a preview of subscription

content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $259.00 per year only $21.58 per issue

Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL

ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS EARLY SYSTEMIC INFLAMMATION INDUCES

NEURODEVELOPMENTAL DISORDERS: RESULTS FROM ARTEMIS, A FRENCH MULTICENTER STUDY OF JUVENILE RHEUMATISMS AND SYSTEMIC AUTOIMMUNE AND AUTO-INFLAMMATORY DISORDERS AND META-ANALYSIS Article 06

February 2023 ASSOCIATION OF ANTENATAL STEROID ADMINISTRATION WITH NEONATAL MORBIDITIES AMONG LATE PRETERM MULTIPLE GESTATION INFANTS Article 01 October 2024 PREMATURE BIRTH CARRIES A HIGHER

RISK OF NEPHROTIC SYNDROME: A COHORT STUDY Article Open access 19 October 2021 REFERENCES * Gowdie P, Tse S . Juvenile idiopathic arthritis. _Pediatr Clin N Am_ 2012; 59 (2): 301–327.

Article  Google Scholar  * Kelly J, Beresford MW . Juvenile idiopathic arthritis: symptoms and diagnosis. _Br J School Nurs_ 2012; 7 (3): 117–120. Article  Google Scholar  * Klippel JH .

Juvenile rheumatoid arthritis. In: Klippel JH, Stone JH, Crofford LeJ, White PH (eds). _Primer on the Rheumatic Diseases_, 2nd edn. Springer Arthritis Foundation: Atlanta, GA, USA, 2001.

Google Scholar  * Sacks JJ, Helmick CG, Luo YH, Ilowite NT, Bowyer S . Prevalence of and annual ambulatory health care visits for pediatric arthritis and other rheumatologic conditions in

the United States in 2001–2004. _Arthritis Care Res_ 2007; 57 (8): 1439–1445. Article  Google Scholar  * Eisenstein E, Berkun Y . Diagnosis and classification of juvenile idiopathic

arthritis. _J Autoimmun_ 2014; 48: 4931–4933. Google Scholar  * Ostensen M . Pregnancy in patients with a history of juvenile rheumatoid arthritis. _Arthritis Rheum_ 1991; 34 (7): 881–887.

Article  CAS  Google Scholar  * Chen J, Ford J, Roberts C, Simpson J, March L . Pregnancy outcomes in mothers with juvenile idiopathic arthritis: a population-based study. _Rheumatology_

2013; 52 (6): 1119–1125. Article  CAS  Google Scholar  * Lin H, Chen S, Lin H, Chen Y . Increased risk of adverse pregnancy outcomes in mothers with rheumatoid arthritis: a nationwide

population-based study. _Ann Rheum Dis_ 2010; 69 (4): 715–717. Article  Google Scholar  * Skomsvoll J, Ostensen M, Irgens L, Baste V . Pregnancy complications and delivery practice in

mothers with connective tissue disease and inflammatory rheumatic disease in Norway. _Acta Obstetr Gynecol Scand_ 2000; 79 (6): 490–495. Article  CAS  Google Scholar  * Agency for Healthcare

Research and Quality Healthcare Cost and Utilization Project (HCUP) _Introduction to the HCUP Nationwide Inpatient Sample (NIS)_. Agency for Healthcare Research and Quality: Rockville, MD,

USA, 2013. Available at: http://www.hcup-us.ahrq.gov/db/nation/nis/NIS_Introduction_2011.pdf (date last accessed 1 June 2015). * Agency for Healthcare Research and Quality Healthcare Cost

and Utilization Project (HCUP) _Introduction to the HCUP Nationwide Inpatient Sample (NIS)_. Agency for Healthcare Research and Quality: Rockville, MD, USA, 2014. Available at:

http://www.hcup-us.ahrq.gov/db/nation/nis/NISIntroduction2012.pdf (date last accessed 1 June 2015). * Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project

(HCUP). _HCUP Coding Practices_. Agency for Healthcare Research and Quality: Rockville, MD, USA. Available at: http://www.hcup-us.ahrq.gov/db/coding.pdf (date last accessed 1 June 2015). *

National Center for Health Statistics In: 2009 ICD Codes. Available at: http://icd9cm.chrisendres.com/index.php (last accessed 20 April 2015). * Centers for Medicare and Medicaid Services.

In: _ICD Code Lookup_. Available at: 2015, http://www.cms.gov/medicare-coverage-database/staticpages/icd-9-code-lookup.aspx (last accessed 20 April 2015). Download references AUTHOR

INFORMATION AUTHORS AND AFFILIATIONS * Newborn Services, The George Washington University Hospital, Washington, DC, USA M A Mohamed, C Goldman, M El-Dib & H Aly Authors * M A Mohamed

View author publications You can also search for this author inPubMed Google Scholar * C Goldman View author publications You can also search for this author inPubMed Google Scholar * M

El-Dib View author publications You can also search for this author inPubMed Google Scholar * H Aly View author publications You can also search for this author inPubMed Google Scholar

CORRESPONDING AUTHOR Correspondence to M A Mohamed. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no conflict of interest. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT

THIS ARTICLE CITE THIS ARTICLE Mohamed, M., Goldman, C., El-Dib, M. _et al._ Maternal juvenile rheumatoid arthritis may be associated with preterm birth but not poor fetal growth. _J

Perinatol_ 36, 268–271 (2016). https://doi.org/10.1038/jp.2015.193 Download citation * Received: 26 June 2015 * Revised: 21 October 2015 * Accepted: 03 November 2015 * Published: 17 December

2015 * Issue Date: April 2016 * DOI: https://doi.org/10.1038/jp.2015.193 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link

Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative