In pregnant women with axial spondyloarthritis (axSpA), disease activity is highest during the second trimester but is generally low and stable from the planning period of pregnancy through 1 year after delivery, according to results published online in Rheumatology.

The study included 179 pregnancies in 166 women with axSpA from a Norwegian nationwide register. The researchers assessed disease activity at 7 points before, during, and after pregnancy using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).

During the second trimester, participants reported the highest disease activity and worst self-reported pain, with 45% of participants having active disease. Disease activity in the second trimester was significantly higher than at 6 weeks postpartum (mean BASDAI 3.97 vs 3.46; P =.005). Aside from the second trimester, disease activity was stable throughout pregnancy.


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In addition, participant self-reported mental health was relatively stable. However, participants reported significantly better mental health 6 weeks postpartum compared with the first trimester (mean RAND-36 mental health score, 79.3 vs 73.2; P <.001).

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The results also showed that the participants’ physical functioning was significantly worse in the third trimester compared with postpartum (mean Bath Ankylosing Spondylitis Functional Index score, 3.6 vs 2.6; P <.001).

“Future research on pregnancy in women with axSpA should differentiate between subgroups of the disease and aim to include objective assessment of inflammation,” the researchers wrote.

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Reference

Ursin K, Lydersen S, Skomsvoll JF, Wallenius M. Disease activity during and after pregnancy in women with axial spondyloarthritis: a prospective multicentre study [published online March 14, 2018]. Rheumatology. doi:10.1093/rheumatology/key047