Poster Session 4
Uri Amikam, MD, MHA (he/him/his)
MFM Specialist
Lis Maternity & Women's Hospital
Ramat-Hasharon, HaMerkaz, Israel
Ahmad badeghiesh, MD, MPH
Department of Obstetrics and Gynecology, King Abdulaziz University, Rabigh Branch
Rabigh, Makkah, Saudi Arabia
Haitham Baghlaf, MD, MPH
Assistant professor
Department of Obstetrics and Gynecology, University of Tabuk, Tabuk, Saudi Arabia, Tabuk, Saudi Arabia
Richard Brown, MD
Maternal Fetal Medicine Specialist
McGill University
Montreal, Quebec, Canada
Michael H. Dahan, MD
McGill University
Montreal, Quebec, Canada
Inflammatory Arthritis (IA) is a common pathology among reproductive-aged women. While abundant data exists regarding pregnancy outcomes in the more common IA subtypes, data is scarce regarding these outcomes in rare IA subtypes. We aimed to compare pregnancy and perinatal outcomes between women who suffered from rare types of IA and those who did not.
Study Design: A retrospective cohort study using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). Included in the study were all pregnant women who delivered or had a maternal death in the US (2004-2014) with an ICD-9 diagnosis of any of the following rare IA subtypes: Arthritis Nodosa, Acute Febrile Mucocutaneous Lymph node, Hypersensitivity Angiitis, Wegner Granulomatosis, Giant Cell Arteritis, and Takayasu Arteritis. We divided the cohort into women with rare IA (study group) and women without (control group). Obstetric and perinatal outcomes were compared between the two groups using multivariate logistic regression adjusting for potential confounders.
Results: A total of 9,096,788 women met the inclusion criteria. Amongst them, 335 women (3.7/100,000) had a diagnosis of rare IA. Women with rare IA, compared to those without, were more likely to be older; Caucasian; in the highest income quartile; be insured by private insurance; and suffer from obesity, pregestational diabetes mellitus, thyroid disorders, and chronic hypertension (p < 0.05, all). Patients in the rare IA group, compared to those without, had a higher rate of hypertensive disorders of pregnancy (HDP) (aOR 1.89, 95% CI 1.4-2.56, p< 0.001); preterm delivery (aOR 1.76, 95% CI 1.28-2.42, p< 0.001); and blood products transfusion (aOR 3.68, 95% CI 2.14-6.34, p< 0.001); with lower rates of spontaneous vaginal delivery (SVD) (aOR 0.76, 95% CI 0.61-0.94, p=0.012); and a higher rate of congenital anomalies (aOR 4.1, 95% CI 2.03-8.31, p< 0.001).
Conclusion: Women with rare IA had a higher incidence of maternal complications, including HDP and preterm delivery, as well as an increased risk of congenital anomalies.
