Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study
Background There is sparse documentation on pregnancy outcomes in women with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Data on disease activity are often lacking, preventing the direct investigation of the effect of inflammation on pregnancy outcomes. A caesarean section (CS) im...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-03-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/9/1/e002760.full |
| _version_ | 1811160254837161984 |
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| author | Stian Lydersen Marianne Wallenius Bente Jakobsen Carina Götestam Skorpen Kjell Åsmund Salvesen Hege Suorza Svean Koksvik |
| author_facet | Stian Lydersen Marianne Wallenius Bente Jakobsen Carina Götestam Skorpen Kjell Åsmund Salvesen Hege Suorza Svean Koksvik |
| author_sort | Stian Lydersen |
| collection | DOAJ |
| description | Background There is sparse documentation on pregnancy outcomes in women with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Data on disease activity are often lacking, preventing the direct investigation of the effect of inflammation on pregnancy outcomes. A caesarean section (CS) implies a higher risk for complications than vaginal delivery. It delays mobilisation after birth necessary to counteract inflammatory pain and stiffness.Objective To explore a possible association of inflammatory active disease and CS rates in women with axSpA and PsA.Methods Data from the Medical Birth Registry of Norway (MBRN) were linked with data from RevNatus, a Norwegian nationwide observational register recruiting women with inflammatory rheumatic diseases. Singleton births in women with axSpA (n=312) and PsA (n=121) included in RevNatus 2010–2019 were cases. Singleton births, excluding mothers with rheumatic inflammatory diseases, registered in MBRN during the same period time (n=575 798) served as population controls.Results CS occurred more frequently in both axSpA (22.4%) and PsA (30.6%) groups compared with population controls (15.6%), with even higher frequencies in inflammatory active axSpA (23.7%) and PsA (33.3%) groups. Compared with population controls, women with axSpA had higher risk for elective CS (risk difference 4.4%, 95% CI 1.5% to 8.2%) but not emergency CS. Women with PsA had higher risk for emergency CS (risk difference 10.6%, 95% CI 4.4% to 18.7%) but not elective CS.Conclusion Women with axSpA had higher risk for elective and women with PsA for emergency CS. Active disease amplified this risk. |
| first_indexed | 2024-04-10T05:54:24Z |
| format | Article |
| id | doaj.art-cc44bb8c17964f70b617e068f4be52c5 |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2024-04-10T05:54:24Z |
| publishDate | 2023-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-cc44bb8c17964f70b617e068f4be52c52023-03-03T21:30:11ZengBMJ Publishing GroupRMD Open2056-59332023-03-019110.1136/rmdopen-2022-002760Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based studyStian Lydersen0Marianne Wallenius1Bente Jakobsen2Carina Götestam Skorpen3Kjell Åsmund Salvesen4Hege Suorza Svean Koksvik5Mental Health, Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, NorwayNorwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Dept of Rheumatology, St Olavs Hospital Trondheim University Hospital, Trondheim, NorwayNorwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Dept of Rheumatology, St Olavs Hospital Trondheim University Hospital, Trondheim, NorwayRheumatology, Helse More og Romsdal HF, Alesund, NorwayClinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, NorwayNorwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Dept of Rheumatology, St Olavs Hospital Trondheim University Hospital, Trondheim, NorwayBackground There is sparse documentation on pregnancy outcomes in women with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Data on disease activity are often lacking, preventing the direct investigation of the effect of inflammation on pregnancy outcomes. A caesarean section (CS) implies a higher risk for complications than vaginal delivery. It delays mobilisation after birth necessary to counteract inflammatory pain and stiffness.Objective To explore a possible association of inflammatory active disease and CS rates in women with axSpA and PsA.Methods Data from the Medical Birth Registry of Norway (MBRN) were linked with data from RevNatus, a Norwegian nationwide observational register recruiting women with inflammatory rheumatic diseases. Singleton births in women with axSpA (n=312) and PsA (n=121) included in RevNatus 2010–2019 were cases. Singleton births, excluding mothers with rheumatic inflammatory diseases, registered in MBRN during the same period time (n=575 798) served as population controls.Results CS occurred more frequently in both axSpA (22.4%) and PsA (30.6%) groups compared with population controls (15.6%), with even higher frequencies in inflammatory active axSpA (23.7%) and PsA (33.3%) groups. Compared with population controls, women with axSpA had higher risk for elective CS (risk difference 4.4%, 95% CI 1.5% to 8.2%) but not emergency CS. Women with PsA had higher risk for emergency CS (risk difference 10.6%, 95% CI 4.4% to 18.7%) but not elective CS.Conclusion Women with axSpA had higher risk for elective and women with PsA for emergency CS. Active disease amplified this risk.https://rmdopen.bmj.com/content/9/1/e002760.full |
| spellingShingle | Stian Lydersen Marianne Wallenius Bente Jakobsen Carina Götestam Skorpen Kjell Åsmund Salvesen Hege Suorza Svean Koksvik Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study RMD Open |
| title | Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study |
| title_full | Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study |
| title_fullStr | Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study |
| title_full_unstemmed | Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study |
| title_short | Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: a population-based study |
| title_sort | caesarean section in women with axial spondyloarthritis and psoriatic arthritis a population based study |
| url | https://rmdopen.bmj.com/content/9/1/e002760.full |
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