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Spondyloarthritis Affects Pregnancy Outcomes

A Danish registy has shown that the the prevalence of Spondyloarthritis (SpA) diagnosed prior to delivery has increased 5 fold in the last two decades and that SpA is associated with an increased risk of adverse pregnancy outcomes (APO).

Researchers used data and outcomes from the Danish Medical Birth Register and 1,199,610 singleton pregnancies between 1997-2016. They analyzed those individuals identified as SpA or related subtypes (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel diseases, and undifferentiated SpA). 

Between 1997 and 2016 the prevalence of SpA diagnosed prior to labor increased from 0.1% in 1997 to 0.6% in 2016.

Comparing women without SpA to women with SpA, APOs were significantly increased for preterm birth (OR 1.56 [95% CI: 1.33-1.83]), elective cesarean section (OR: 1.44 [95% CI: 1.26-1.64]), emergency cesarean section OR 1.17 [95% CI: 1.04-1.33]), and use of epidural (OR 1.11 [95% CI: 1.02-1.20]).

The odds ratios for small for gestational age birth and preeclampsia were not increased for SpA women compared to controls.

There were no differences between the subtypes of SpA.

SpA women who become pregnant may be at increased risk for preterm birth or cesarean sections but not for preeclampsia or low gestational birth weight.  The increase in the observed prevalence of pregnancy in SpA may reflection changing attitudes by physicians and SpA patients. 

The author has no conflicts of interest to disclose related to this subject

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