OP0211 PATERNAL INFLAMMATORY ARTHRITIS IS ASSOCIATED WITH A HIGHER RISK OF MISCARRIAGES: RESULTS OF A LARGE MULTICENTER STUDY (IFAME-FERTILITY)

Abstract

Background:The effect of inflammatory arthritis (IA) on pregnancy outcomes has been studied mainly in women. Paternal older age, sperm DNA integrity and certain genetic defects have been associated with worse pregnancy outcomes (1). However, pregnancy outcomes of partners of men with IA have never been studied.Objectives:To describe the pregnancy characteristics and outcomes of partners of men diagnosed with IA.Methods:We performed a multicenter cross-sectional retrospective study conducted in eight Dutch hospitals. Men with IA (Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA) and Spondyloarthritis (SpA)) who were over 40 years old and indicated that their family size was complete were invited to participate. Participants completed a digital questionnaire that included pregnancy-related questions and questions regarding their demographic and clinical information. To analyze the impact of IA on pregnancy outcomes, pregnancies were classified into two groups; pregnancies that occurred after diagnosis of IA and before the diagnosis of IA.Results:In total 628 male participants diagnosed with IA were included. 408 men reported 897 singleton pregnancies that resulted in 794 live births. Regarding pregnancy characteristics, pregnancies conceived after diagnosis of IA had a higher mean paternal and maternal age at conception and a lower rate of spontaneous pregnancies (90.91 vs 96.60%, p=<0.005) (See Table 1). With regards to pregnancy outcomes, pregnancies conceived after receiving the diagnosis of IA had a lower rate of live births (86.36% and 89.22%, p=0.053) and a significant higher rate of miscarriages (12.27 vs 7.53%, p=<0.05). After correcting for maternal age and year of pregnancy, pregnancies conceived after the diagnosis of IA had a higher risk of miscarriages (OR 1.71 [CI 1.04-2.81], p<0.05). No statistically significant differences between the two groups were reported for the rates of abortions, preterm births and pregnancy complications.Table 1.Pregnancy characteristics and outcomes.AllpregnanciesPregnancy afterdiagnosis of IAPregnancy before diagnosis of IAP valuePregnancy characteristicsTotal number of pregnancies897220677Maternal age at conception, mean (SD)29.00 (5.00)30.69 (5.16)28.45 (4.83)p<0.005Paternal age at conception, mean (SD)31.31 (5.72)34.27 (6.08)30.49 (5.34)p<0.005Spontaneous pregnancy, n (%)854 (95.21)200 (90.91)654 (96.60)p<0.005Pregnancy duration-months, median (IQR)39 (38-40)39 (38-40)39 (38-40)p=0.928Pregnancy outcomesLive births, n (%)794 (88.52)190 (86.36)604 (89.22)p=0.053Miscarriage, n (%)78 (8.70)27 (12.27)51 (7.53)p<0.05Abortion, n (%)25 (2.78)3 (1.36)22 (3.25)p=0.128*Medical indication5 (20.00)0 (0)5 (22.73)*Personal reasons20 (80.00)3 (100.00)17 (77.27)Pre-term birth149 (16.61)31 (14.09)118 (17.43)p=0.248Pregnancy complicationsNo complications during pregnancy, n (%)754 (84.34)184 (83.64)570 (84.57)p=0.741Hypertensive disorders(hypertension, pre/eclampsia), n (%)41 (4.57)8 (3.64)33 (4.87)p=0.445Gestational Diabetes Mellitus11 (1.28)2 (0.94)9 (1.38)p=0.619Growth restriction12 (1.34)1 (0.45)11 (1.65)p=0.193Conclusion:This is the largest study to describe the pregnancy characteristics and outcomes of partners of men diagnosed with IA and the first to demonstrate that paternal IA is associated with a higher risk of miscarriage. Prospective studies are needed to corroborate these findings.