Pregnancy outcomes in women with rheumatoid arthritis in Washington State

Objective: To determine whether rheumatoid arthritis (RA) is associated with increased adverse obstetric or neonatal outcomes. Study design and setting: Washington State birth records and hospital discharge data between 1987 and 2001 identified a cohort of women with rheumatoid arthritis and a comparison group of women without rheumatoid arthritis. Pregnancy and neonatal outcomes were compared using general linear models for common outcomes, calculating approximate relative risks and 95 % confidence intervals. Results: There were 243 women with rheumatoid arthritis and 2559 controls. Infants of women with rheumatoid arthritis had increased risk of cesarean delivery (adjusted approximate relative risk, aRR = 1.66, 95% CI (1.22, 2.26)), prematurity (aRR = 1.78, 95% CI (1.21, 2.60)), and longer birth hospitalization (aRR = 1.86, 95 % CI (1.32, 2.60)) compared to those born to women without rheumatoid arthritis. Conclusions: We speculate that the increased risks for cesarean delivery, prematurity, and longer hospitalization at birth among infants born to women with rheumatoid arthritis may be due to the pathophysiologic changes associated with rheumatoid arthritis or medications used to treat the disease.