Association between pregnant women with rheumatoid arthritis and preeclampsia: A systematic review and meta-analysis.

Lv Tian, Zhiyuan Zhang, Yuting Mao, Minru Zong

Journal: Medicine 2023;102(26):e34131

PMID: 37390281

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Plain Language Summary

Rheumatoid arthritis (RA) is a chronic autoimmune condition that predominantly affects women, particularly those of childbearing age. The intersection of RA with pregnancy presents unique challenges, as it may influence maternal and foetal outcomes. This aim of this study was to investigate the existing literature to evaluate the association between RA in pregnant women and the risk of developing preeclampsia. This study was a systematic review and meta-analysis of eight studies. Results showed that pregnant women with RA had higher odds of suffering from preeclampsia, as well as other complications such as gestational diabetes, spontaneous abortion, and caesarean delivery. Infants born to mothers with RA also showed a higher risk of stillbirth, being small for gestational age, low birth weight, congenital abnormalities, diabetes type 1, and asthma. Authors concluded that there is a significant association between RA in pregnant women and an increased risk of preeclampsia and other adverse maternal and foetal outcomes. It emphasises the importance of close monitoring and management of RA during pregnancy to mitigate these risks.

Abstract

BACKGROUND

To examine the association between pregnant women with rheumatoid arthritis (RA) and the risk of preeclampsia.

METHODS

This study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42022361571. The primary outcome was preeclampsia. Two evaluators independently reviewed the included studies, assessed their risk of bias, and extracted the data. Unadjusted and adjusted ratios with 95% confidence intervals and 95% prediction intervals were calculated. Heterogeneity was quantified using the І2 statistic, where І2 ≥ 50% indicated the presence of significant heterogeneity. Subgroup and sensitivity analyses were performed to test the robustness of the overall findings.

RESULTS

A total of 8 studies, including 10,951,184 pregnant women, of whom 13,333 were diagnosed with RA, met the inclusion criteria. Meta-analysis revealed that pregnant women with RA were significantly more likely to develop preeclampsia than those without RA (pooled odds ratio, 1.66; 95% confidence interval, 1.52-1.80; P < .001; І2 < .001).

CONCLUSION

RA during pregnancy is associated with higher odds of preeclampsia.

Address: School of Nursing, Jilin University, Changchun, China.; Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, China.; Department of Rehabilitation, The Third Hospital of Jilin University, Changchun, China.

DOI: 10.1097/MD.0000000000034131