HealthDay News — For women with rheumatoid arthritis (RA), adherence to an ideal clinical pathway during pregnancy is associated with a reduced risk for miscarriage and complicated birth, according to a study published online Jan. 7 in Arthritis Care & Research.

Alessandra Bortoluzzi, M.D., Ph.D., from the University of Ferrara in Italy, and colleagues examined the relationship between seven health care quality indicators (HCQI) and adverse pregnancy outcomes (APO; complicated birth or miscarriage). Data were included from first pregnancies in 443 women with RA and 6,097 women from the general population (controls).

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The researchers found that among patients with RA, compared with those who did not follow the ideal pathway, those who followed the ideal pathway had a reduced risk for overall APO (odds ratio, 0.60; 95 percent confidence interval, 0.39 to 0.94) and miscarriage/perinatal death (odds ratio, 0.40; 95 percent confidence interval, 0.24 to 0.69). Compared with the general population, patients with RA who met all HCQI during pregnancy had similar risks for APO (odds ratio, 0.92; 95 percent confidence interval, 0.61 to 1.38) and miscarriage/perinatal death (odds ratio, 0.77; 95 percent confidence interval, 0.47 to 1.29).

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“Our findings suggest the adherence to an ideal clinical pathway should be strived for as much as possible in order to offer the best possible chances for a successful pregnancy to women with RA,” the authors write.

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