Abstract
To study a sample of rheumatoid arthritis (RA) patients for their gynecological/obstetric history and compare them to controls to determine their influences on number of pregnancies, menarche, menopause and reproductive years following RA onset. This is a cross-sectional study of 122 RA patients and 126 controls. Patients and controls were questioned about age of menarche, age of menopause, number of pregnancies and abortions. Reproductive years were calculated as the difference between age at menopause and age at menarche. For comparison, we used the Mann-Whitney, unpaired t, chi-squared, and Spearman tests. The adopted significance was 5%. In the RA patients with disease beginning in the postmenopausal years, the period of reproductive years (age at menopause - age of menarche) showed a positive correlation with age at disease onset (rho = 0.46; 95% confidence interval [CI] = 0.20-0.55 with p = 0.0008). The number of pregnancies was higher in patients with postmenopausal disease onset when compared with those with premenopausal disease onset (median of 3 with interquartile range [IQR] = 2-4 versus median of 2 with IQR = 1-3; p = 0.009), and RA patients had more pregnancies than controls (p = 0.0002). The present study shows that, in our population, the duration of reproductive years and the number of pregnancies are linked to the onset of RA.
Highlights
Rheumatoid arthritis (RA) is the most common connective tissue disease, with a prevalence of 1% in the general population.[1]
Similar to other connective tissue diseases, RA has a female predominance; the ratio ranges from 4 women to 1 man, when the disease begins in the reproductive years, to 2 to 1, when it initiates after 60 years.[2,3]
Patients with disease onset prior to 16 years of age or having any other associated inflammatory disease were excluded. This is a sample that encompasses all female patients with RA diagnosis from a single rheumatology unit from a university hospital that has a specialized rheumatoid arthritis outpatient clinic and that visited for regular consultations during the period of June to July 2020
Summary
Rheumatoid arthritis (RA) is the most common connective tissue disease, with a prevalence of 1% in the general population.[1]. Rheumatoid arthritis and female reproduction have been linked in the literature for decades, and the decrease in its symptoms during pregnancy is well recognized, with exacerbation of the disease in the postpartum period.[5] The gynecological and obstetrical history have been studied in this context; contradictory results have been obtained. According to an epidemiological investigation in a Swedish cohort, having more than one pregnancy amplified the risk of anti-citrullinated-protein antibody (ACPA)-negative RA in females of reproductive age.[6] Guthrie et al.[7] studied 310 RA patients and 1,418 controls and found that parous women were around 40% less likely to receive the RA diagnosis.[6,7] Another study, by Peschken et al.,[8] showed that greater parity reduced the chances of being diagnosed with RA. A relationship between higher number of pregnancies and delayed onset of RA has been found.[7,9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
