Rheumatic diseases have a broad impact on reproductive success and pregnancy outcomes, according to a study published online March 20 in Rheumatology.
Anne M. Kerola, M.D., Ph.D., from Helsinki University Hospital, and colleagues examined the impact of rheumatic diseases on reproductive health measures, comparing the impacts to those of other immune-mediated diseases (IMDs). The analysis included nearly 5.4 million Finnish citizens born between 1964 and 1984 and diagnosed with any of the 19 IMDs before age 30 years (women) or before age 35 years (men), as well as matched controls (1:20) by birth year, sex, and education.
The researchers found that systemic lupus erythematosus (SLE), juvenile idiopathic arthritis, and seropositive rheumatoid arthritis were associated with higher rates of childlessness and fewer children. Many IMDs were associated with increased risks for preeclampsia, newborns being small for gestational age, preterm delivery, nonelective Caesarean sections, and need of neonatal intensive care, including SLE, Sjögren syndrome, type 1 diabetes, and Addison disease, which showed more than a twofold greater risk for some of these outcomes. Moderate increases in risk (1.1- to 1.5-fold higher) were seen for diverse adverse pregnancy outcomes with most rheumatic diseases, with similar effects in inflammatory bowel disease, celiac disease, asthma, immune thrombocytopenia, and psoriasis.
“Despite seeing an elevated risk for diverse childbearing problems in rheumatic and other immune-mediated diseases, many of the complications are still fairly rare,” Kerola said in a statement. “Pregnancies in women with rheumatic diseases are carefully followed up to tailor medications appropriately, which helps reduce risks.”
Several authors disclosed ties to the pharmaceutical industry.
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