Active Juvenile Idiopathic Arthritis Confers Greater Risk for Emergency Cesarean Section

Pregnant women with active juvenile idiopathic arthritis (JIA) may be at greater risk for emergency cesarean section, according to study results published in Rheumatology Advances in Practice.

Investigators examined the association between active inflammatory JIA and the occurrence of elective and emergency cesarean section.

A population-based study was conducted with data sourced from the Medical Birth Registry of Norway and a nationwide register comprised of women aged at least 16 years diagnosed with rheumatic diseases who were pregnant or planning to become pregnant.

Singleton births among women diagnosed with JIA were included in the study, along with a control group comprised of births among women without inflammatory rheumatic diseases. The main study outcomes were prevalence of overall, elective, and emergency cesarean section.

A total of 196 singleton births among women with JIA and 798 births among the control group were included in the analysis. The majority of women with JIA had inactive (72.4%) vs active (27.6%) disease status.

Overall, cesarean section was more prevalent among women with JIA (20.4%) vs the control group (15.6%), occurring most frequently among those with active JIA (31.4%).

The prevalence of elective cesarean section was comparable between women with JIA and the control group (6.6% vs 5.6%), with no differences noted between women with active vs inactive JIA.

Emergency cesarean section occurred more frequently among women with JIA (13.8%) vs the control group (10.0%), with the highest frequency noted among women with active JIA (23.5%).

Women with active JIA were associated with a 13.5% higher risk for emergency cesarean section vs the control group, while risk among women with inactive JIA vs the control group was similar.

Study limitations included the lack of validated disease activity assessments for pregnant women with JIA. Additionally, the proportion of women with active JIA may have been overestimated.

The study authors concluded, “Women with JIA who are planning pregnancy or are pregnant are advised to contact their rheumatologist for tighter follow-up, with a goal of well controlled disease during pregnancy.”