Adverse Pregnancy Outcomes and Rheumatoid Arthritis: a Retrospective Matched Cohort Study

 Rheumatoid Arthritis (RA) is an autoimmune-driven chronic systemic inflammatory disease. It could result in miscarriage, pre-eclampsia, and preterm labor, among other unfavorable pregnancy outcomes. Thus, this study was conducted to investigate the adverse pregnancy outcomes in pregnant women with RA.

 Two cohorts of pregnant women with and without RA referred to the Ayatollah Mousavi Hospital's Gynecology and Obstetrics Clinic in Zanjan, Iran, during 2019-2020 were enrolled in a retrospective matched cohort study. Using their medical records, each participant completed a checklist of study variables. We used binary Logistic regression, chi-square test, Analysis of Variance, and independent samples t-test to analyze data using SPSS v.23.

 The study included 280 pregnant women. The mean age of the RA and control group (pregnant women without RA) was 32.4 ± 6.6 and 29.5 ± 6.7 years, respectively. The most prevalent adverse outcome was spontaneous abortion (54, 19.28%), which was significantly higher in the RA group (25% vs. 13.6%, P= 0.015). Cesarean section (24.3% vs. 10.7%, P= 0.003) and low birth weight (LBW) were both significantly higher in the RA group (15% vs. 5%, P= 0.005). RA increased the probability of spontaneous abortion, cesarean section, and LBW by more than 1.3 (odds ratio, 1.38; 95% CI, 0.45-5.46; P= 0.017), 2.2 (odds ratio, 2.24; 95% CI, 1.29-6.54; P =0.004), and 2.6 (odds ratio, 2.67; 95% CI, 1.86-7.05; P= 0.008) times, respectively.

 Pregnant women with RA are more likely to experience spontaneous abortion, cesarean section, and having LBW infants comparing to pregnant women without RA.