Impact of Spondyloarthritis on Pregnancy Outcome: A Descriptive Analysis from a Specialized Center in Qatar

Abstract

Introduction

Spondyloarthritis (SpA) most commonly presents at childbearing age; thus, pregnancy is of concern. However, data on pregnancy outcomes in these patients are limited.

Purpose

This study aimed to retrospectively describe pregnancy outcomes in patients with SpA from the Middle East.

Patients and Methods

We reviewed the electronic health records of all pregnant women attending a specialized pregnancy and rheumatic disease clinic between 2016 and 2022. All pregnant patients diagnosed with axial spondyloarthritis (axSpA) and peripheral SpA were included. Data on adverse maternal and fetal outcomes were collected.

Results

Fifty-seven eligible pregnancies were identified from hospital records: 10 pregnancies ended in early miscarriage. Forty-seven pregnancies resulted in live singleton births, 25 in patients with peripheral SpA and 22 with axSpA. Human leukocyte antigen B27 was positive in 7 (15%) patients and only in women with axSpA. Twenty-nine (64%) patients received treatment throughout pregnancy. Consistent biologic disease-modifying antirheumatic drug (bDMARD) use was high, in eight (32%) patients with peripheral SpA and in nine (41%) with axSpA. A conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) was used as treatment in 11 (50%) patients with peripheral SpA and two (8%) with axSpA. Twenty-two (53%) neonates were delivered by cesarean section, 19 (40%) by normal vaginal delivery and three (6%) by assisted delivery. Additionally, 44 (94%) deliveries were at term, and 42 (91%) neonates had a normal birth weight. Exploration of a subgroup showed no difference in reported outcomes between patients treated with bDMARD and those treated with csDMARD.

Conclusion

This descriptive study reports a high rate of favorable pregnancy outcomes in patients with SpA. There was no evidence to suggest a difference in pregnancy outcomes between women with axSpA and those with peripheral SpA. This study was one of the first reports from the Middle East. Further studies with larger sample size are warranted.

Keywords:

• axial spondyloarthritis
• pregnancy
• pregnancy outcomes
• neonatal health
• maternal health

Abbreviations

ASAS, Assessment of Spondyloarthritis International Society; axSpA, axial spondyloarthritis; CS, cesarean section; bDMARD, biologic disease-modifying anti-rheumatic drug; csDMARD, conventional synthetic disease-modifying anti-rheumatic drug; HLA-B27, human leukocyte antigen B27; NICU, neonatal intensive care unit; NSAID, non-steroidal anti-inflammatory drug; NVD, normal vaginal delivery; SD, standard deviation; SpA, spondyloarthritis.

Data Sharing Statement

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Acknowledgments

Data were collected by the research coordinator Hadeel Ashour of the Department of Rheumatology, Hamad Medical Corporation. Connect Communications (Dubai, UAE) provided medical writing support.

Disclosure

The authors report there are no competing interests to declare.

Additional information

Funding

The study was approved by the Hamad Medical Corporation Medical Research Center without funding.