"Navigating Pregnancy with Rheumatoid Arthritis: Challenges and Outcomes Explored"

Abstract (required)

Objective:

To evaluate maternal and neonatal outcomes in pregnancies complicated by rheumatoid arthritis (RA), focusing on the prevalence of pregnancy and postnatal flares, maternal complications, and neonatal outcomes.

 

Design:

This retrospective study analyzed clinical data to explore the impact of RA on pregnancy outcomes. The study aimed to identify predictors of maternal and neonatal complications and assess the efficacy of multidisciplinary care.

 

Method:

We reviewed medical records of 92 pregnant women with RA who delivered between January 2015 and December 2022. Data included demographics, obstetric history, disease duration, medication use, and clinical features of flares. Maternal outcomes such as gestational diabetes mellitus (GDM), preeclampsia (PE), preterm labor (PTL), and postpartum autoimmune flares were documented. Neonatal outcomes, including gestational age, birth weight, NICU admissions, and congenital anomalies, were also evaluated. Data analysis used descriptive statistics and chi-square tests to determine associations between RA-related complications and outcomes.

 

Results:

The majority of participants were aged 20–30 years (87.8%), with 84.8% having RA for ≤2 years. Pregnancy-related flares occurred in 39.1% of cases, while 46.7% experienced postnatal flares. Maternal complications included GDM (15.2%, p < 0.05), PE (8.7%, p = 0.03), and PTL (4.3%, p = 0.04). Preterm delivery was observed in 18.5% (p = 0.02), low birth weight in 18.5% (p < 0.05), and NICU admissions in 13% (p = 0.01). Significant associations were found between active disease flares and higher rates of preeclampsia and preterm birth. No neonatal deaths or congenital anomalies were reported. Active disease management with corticosteroids and immunosuppressants improved maternal stability but required balancing teratogenic risks. Multidisciplinary care, including rheumatology, obstetrics, and neonatology teams, was integral to improving outcomes.

 

Conclusions:

RA in pregnancy is associated with significant maternal and neonatal complications, particularly postnatal autoimmune flares, GDM, and preterm births. Statistically significant associations between disease activity and complications highlight the need for intensive management strategies. Multidisciplinary management and tailored medication regimens are critical to achieving favorable outcomes. Future research should focus on optimizing preconception disease control and assessing the long-term impacts of maternal RA and its treatment on neonatal health. This study highlights the importance of comprehensive care and evidence-based guidelines to manage high-risk pregnancies in women with RA.

 

 

Categories (required)
Maternal medicine
Authors and affiliations (required)
Dr Nina Navakumar (Presenting) ninanavakumar@yahoo.co.in
KIMSHEALTH, Thiruvananthapuram, India
Dr Nazneen K ninanavakumar@yahoo.co.in
KIMSHEALTH, Thiruvananthapuram, India
Dr Vidyalekshmy R ninanavakumar@yahoo.co.in
KIMSHEALTH, Thiruvananthapuram, India
Dr Rajesh S ninanavakumar@yahoo.co.in
KIMSHEALTH, Thiruvananthapuram, India
Dr Bhuvanesh M ninanavakumar@yahoo.co.in
KIMSHEALTH, Thiruvananthapuram, India
Dr Deepak Paul dkpl2004@gmail.com
Sree Gokulam Medical College and Research Foundation, Thiruvananthapuram, India
Dr Nini Navakumar nininavakumar@gmail.com
Sree Gokulam Medical College and Research Foundation, Thiruvananthapuram, India