RESEARCH - Miscarriage but not fecundity is associated with progression of joint destruction in RA

[Guest guest]

Ann Rheum Dis. 2004 Aug;63(8):956-60.

Miscarriage but not fecundity is associated with progression of joint

destruction in rheumatoid arthritis.

van Dunne FM, Lard LR, Rook D, Helmerhorst FM, Huizinga TW.

Department of Rheumatology, Leiden University Medical Centre, Leiden,

Netherlands.

OBJECTIVE: To determine whether reproductive history before disease onset is

associated with severity of joint destruction in rheumatoid arthritis.

METHODS: A special early arthritis clinic (EAC) was established at the

department of rheumatology of Leiden University Medical Centre. General

practitioners were encouraged to refer patients with joint complaints to

this clinic, where the diagnosis of rheumatoid arthritis was made by a

rheumatologist. In all, 113 female patients with definite rheumatoid

arthritis were included in this study. A structured questionnaire was

administered and joint damage was assessed by sequential x rays of the hands

and feet, using the modified Sharp score. RESULTS: The length of time of

unprotected intercourse until first pregnancy (fecundity) was comparable

with data from earlier studies, with 16% of the patients reporting a time to

first pregnancy of more than 12 months. Fecundity did not reflect the extent

of joint damage over time. The miscarriage rate was 15% per pregnancy,

comparable to population figures (12-15%). A significant increase in joint

damage over a two year follow up was found in patients with rheumatoid

arthritis who had experienced at least one miscarriage compared with those

who had never had a miscarriage (mean modified Sharp scores at 2 years, 24

(95% confidence interval, 15 to 32) and 16 (10 to 23), respectively;

p<0.05). At baseline, the Sharp scores were similar in the two subgroups.

CONCLUSIONS: Miscarriage before disease onset but not fecundity is

associated with the progression of joint damage in rheumatoid arthritis.

PMID: 15249322

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15249322 & itool=iconabstr & query_hl=43

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org