Effects of Maternal axSpA Disease Activity on Pregnancy Outcomes Examined

pregnant woman in doctor office for checkup
pregnant woman in doctor office for checkup
A systematic review revealed no signal for increased pregnancy loss in patients with axial spondyloarthritis.
The following article is part of conference coverage from the European League Against Rheumatism (EULAR) Congress 2018 in Amsterdam, The Netherlands. Rheumatology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in rheumatology. Check back for the latest news from EULAR 2018.

No signal for increased pregnancy loss was detected in a systematic review of observational studies including women with axial spondyloarthritis (axSpA), according to research presented at the European League Against Rheumatism (EULAR) Congress held in Amsterdam, June 13 to 16, 2018.

Researchers sought to review currently published studies on pregnancy outcomes in women with axSpA to evaluate whether axSpA disease activity was related to adverse fetal outcomes.

A search of EMBASE, MEDLINE, the Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects was performed in October 2017. Studies included were published in English, were observational in nature, and included women with axSpA with reported data on pregnancy outcomes and disease activity during pregnancy. Any studies including women currently taking medications contraindicated in pregnancy were excluded.

A total of 2216 publications were reviewed, resulting in 20 publications reporting on 15 distinct clinical studies. Five studies were identified that measured active axSpA disease activity during pregnancy and the postpartum period using verified disease activity scales, including the Bath Ankylosing Spondylitis Disease Activity Index or the Ankylosing Spondylitis Disease Activity Score with C-reactive protein. 

Six studies compared pregnancy outcomes in patients with axSpA vs healthy control patients. Three of these 6 studies found a higher risk for preterm delivery in patients with axSpA compared with healthy control patients.

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In 2 out of 5 studies reporting on infant birth weight, researchers found higher rates or risk for small-for-gestational-age or low birth weight neonates in patients with axSpA.

Fetal loss, miscarriages, and stillbirths occurred at similar rates in both patients with axSpA and control patients.

“Within the samples reported here, available data suggest that there may be a small increase in preterm births; no signal for increased pregnancy loss was detected,” the authors of the meta-analysis concluded.

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Moltó A, Gensler L, Clowse MEB, et al. Pregnancy outcomes and disease activity in women with axial spondyloarthritis: a systematic literature review. Presented at: European League Against Rheumatism (EULAR) Congress 2018; June 13-16, 2018; Amsterdam, The Netherlands. Abstract THU0242.