The association between immune-mediated inflammatory diseases (IMIDs) and adverse pregnancy outcomes varies with the nature of IMID and the presence of comorbidities, according to a study published online Feb. 1 in eClinicalMedicine.
Yeon Mi Hwang, from the Institute for Systems Biology in Seattle, and colleagues conducted a retrospective cohort study to examine the impact of 12 selected IMIDs on adverse pregnancy outcomes. The analytic cohort included 365,075 people: 5,784 in the IMID group and 359,291 in the non-IMID group.
The researchers found that in the previous 10 years, the prevalence rate of pregnancy of at least 20 weeks duration doubled in people with a previous IMID diagnosis. Of the IMID group, 17 percent had at least one prenatal immunomodulatory medication (IMM) prescription; 48 to 70 percent of the patients taking IMMs before pregnancy continued them throughout pregnancy, depending on the type of IMM. Compared with a matched cohort of people without IMIDs, patients with one or more of the 12 IMIDs had an increased risk for preterm birth (PTB), low birth weight (LBW), small for gestational age, and cesarean section overall (relative risks [95 percent confidence intervals], 1.1 [1.0 to 1.3], 1.2 [1.0 to 1.4], 1.1 [1.0 to 1.2], and 1.1 [1.1 to 1.2], respectively). Risk was not significantly increased for PTB or LBW among patients with rheumatoid arthritis and/or inflammatory bowel disease, after adjustment for comorbidities.
“Each type of autoimmune disease is different, each person has their own medical history, and risk may change over the course of pregnancy,” lead author Jennifer Hadlock, M.D., also from the Institute for Systems Biology, said in a statement. “This study highlights the importance of taking comorbidities into consideration.”
Several authors disclosed ties to the biopharmaceutical industry.
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