The impact of rheumatoid arthritis (RA) on maternal postpartum outcomes was little understood. Researchers evaluated maternal postpartum outcomes in RA using a real-world electronic health record (EHR) cohort. Using more than or equal to 1 delivery ICD-9 or ICD-10-CM code and a proven RA algorithm, they detected probable RA deliveries in a large, de-identified EHR. On chart review, RA cases have to be diagnosed by a rheumatologist. Blood transfusion rates, infection rates up to 6 weeks postpartum as evaluated by a doctor, and length of hospital stay were among the maternal postpartum outcomes. Investigators also found pregnancies among women who did not have autoimmune disorders. They found 202 deliveries after a RA diagnosis and 596 deliveries to people who did not have autoimmune disorders. Postpartum infection rates (8% vs 4%, p=0.10) and red blood cell transfusion rates (2% vs 2%, p=1.00) were similar in RA patients and controls. Postpartum infection was not significantly linked with RA case status (OR=2.10, 95% CI 0.88 – 4.98, p=0.09), whereas preterm birth was (OR=2.11, 95% CI 1.38 – 3.23, p=0.001). Corticosteroids were used by 41% of pregnant women, while tumor necrosis factor inhibitors were used by 13%. Corticosteroid use at delivery was not connected with postpartum maternal infections after correcting for age at delivery and race; however, it was associated with a considerably lower birthweight in RA patients. Women with RA have a higher risk of unfavorable pregnancy outcomes, especially premature birth. However, the research showed that in RA patients, maternal postpartum outcomes such as postpartum infection and blood transfusion are not significantly elevated.

 

Source:www.sciencedirect.com/science/article/abs/pii/S0049017222000269