Disease Activity in Axial Spondyloarthritis Generally Low, Stable During Pregnancy

pregnant woman
pregnant woman
Researchers found that disease activity was highest during the second trimester of pregnancy.

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.

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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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