Women with Rheumatoid Arthritis or Lupus Have Higher Rates of Obstetric Complications: Presented at ACR

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Women with Rheumatoid Arthritis or Lupus Have Higher Rates of Obstetric Complications: Presented at ACR

http://www.docguide.com/news/content.nsf/news/8525697700573E18852570BB006ED9F7SAN DIEGO, CA -- November 16, 2005 -- Women with either systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) have sharply increased risks of obstetric complications compared to other women, according to study findings presented here November 15th at the annual scientific meeting of the American College of Rheumatology (ACR).The research shows that women with SLE have twice the risk of developing hypertensive disorders as do women with RA, and both have significantly higher rates than the general obstetric population.Eliza F. Chakravarty, MD, Assistant Professor of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, United States, presented the findings.Dr. Chakravarty and colleagues designed their study to address two gaps in the literature regarding pregnancies in women with rheumatic disease. First, because most studies of pregnancies in women with SLE have drew data from tertiary-care centers, their findings may not be representative of the range of women with this condition. Second, little is known about pregnancy outcomes in women with RA.The investigators evaluated rates of pregnancies in women with either SLE or RA and compared maternal and fetal outcomes to those of women in the general obstetric population. She said this is the first nationwide study in the United States of pregnancy outcomes in these women, which was based on data from the general population.They used the 2002 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, a database of all discharge records from a nationally representative sample of all hospitals in the United States.Using International Classification of Disease version 9 codes, the researchers identified all obstetric hospitalizations and determined if the women had lupus or rheumatoid arthritis. They also obtained population estimates of hospitalizations and outcomes.There were approximately 4.66 million obstetric hospitalizations in 2002 and of those, approximately 4480 involved women with a diagnosis of SLE; and 1670 involved women with RA.Rates of hypertensive disorders during pregnancy were 23.6% for women with SLE and 11.7% for women with RA (P < .001 for both). Among women in the general obstetric population the rate was 7.9% (P < .001 for SLE, P = .008 for RA), the study found.Results also show that intrauterine growth restriction occurred in 4.1% of pregnancies involving women with SLE and in 3.2% of those involving RA patients. In the general population, the rate was 1.5%.Premature rupture of membranes occurred at similar rates in the three groups.Non-delivery hospitalizations occurred in 27.7% of women with SLE, 17.8% of those with RA, and 11.8% of those in the general population.The researchers concluded that women with SLE or RA should have careful antenatal monitoring.[Presentation title: Obstetric Hospitalizations in the United States for Women with SLE and RA. Abstract 991]