Abstract
BackgroundsIn order to provide juvenile idiopathic arthritis (JIA) patients with better pre-conceptional and prenatal counselling, we investigated the obstetrical and neonatal outcomes among women with Asian descent.MethodsThrough the linkage of Taiwan National Health Insurance database and National Birth Registry, we established a population-based birth cohort in Taiwan between 2004 and 2014. In a case control study design, first children born to mothers with JIA are identified and matched with 5 non-JIA controls by maternal age and birth year. Conditional logistic regression was used to calculate odds ratios for maternal and neonatal outcomes crude and with adjustment.ResultsOf the 2,100,143 newborn, 778 (0.037%) were born to JIA mothers. Among them, 549 first-born children were included in this research. Our result suggested that babies born to mothers with JIA were more likely to have low birth body weight, with an adjusted OR of 1.35(95% CI: 1.02 to 1.79) when compared to babies born to mothers without. No differences were observed in other perinatal complications between women with and without JIA including stillbirth, prematurity, or small for gestational age. The rate of adverse obstetrical outcomes such as caesarean delivery, preeclampsia, gestational diabetes, postpartum hemorrhage and mortality were also similar between the two.ConclusionsAdverse obstetrical and neonatal outcomes were limited among Asian mothers with JIA. Intensive care may not be necessary for JIA mothers and their newborns.
Highlights
Juvenile idiopathic arthritis (JIA) is the most prevalent debilitating rheumatic disease of childhood [1]
We examined the pregnancy outcomes as well as perinatal complications of neonate born to mothers with JIA in a population-based cohort incorporating patients with Asian origin exclusively
As compared to previous study analyzing less than 10 Asian cases, the relatively large sample size in the present study provided sufficient statistical power to detect differences in the risk of adverse birth outcomes and pregnancy morbidities comparing women with and without JIA [26]
Summary
Juvenile idiopathic arthritis (JIA) is the most prevalent debilitating rheumatic disease of childhood [1]. It comprises heterogeneous subtypes of diseases with complex immunopathology that leads to joint inflammation before the age of 16 [2]. 27.1/100,000 women suffered from JIA in Taiwan during the period of 1999 to 2010 [6, 7]. Increasing attentions have been raised on reproduction related issues in patients with rheumatic diseases [8, 9]. Despite the success of conventional and new biological treatments, a substantial percentage of JIA patients will have ongoing active disease into adulthood.
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