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

Figures & data

Figure 1 Flow chart showing inclusion of pregnancies in final analysis.

Abbreviations: SpA, spondyloarthritis; axSpA, axial spondyloarthritis.

Table 1 Maternal Characteristics for Pregnancies with Live Birth (n=47)

	All pregnancies n=47	Peripheral SpA n=25	axSpA n=22
Age (years) mean±SD	30.62±4.69	31.48±5.39	29.64±3.59
Maternal country of origin
South Asia	11 (23%)	4 (16%)	7 (32%)
Southeast Asia	1 (2%)	0 (0%)	1 (5%)
Levant	3 (6%)	3 (12%)	0 (0%)
Gulf	21 (45%)	14 (56%)	7 (32%)
North Africa	11 (23%)	4 (16%)	7 (32%)
HLA-B27 positive	7 (15%)	0 (0%)	7 (32%)
Pre-existing comorbidities
Hypertension	1 (2%)	0 (0%)	1 (5%)
Hypothyroidism	2 (4%)	2 (8%)	0 (0%)
Goiter	2 (4%)	2 (8%)	0 (0%)
Epilepsy	3 (6%)	3 (12%)	0 (0%)
Medication^a	29 (64%)	18 (72%)	11 (50%)
NSAID	2 (4%)	0 (0%)	2 (9%)
csDMARD	13 (28%)	11 (50%)	2 (8%)
bDMARD	17 (36%)	8 (32%)	9 (41%)

Notes: ^aSome patients received more than one medication. One patient was treated with steroids alone and was regarded as not receiving any medications. NSAID treatment was discontinued in all patients at 25 weeks. bDMARD and csDMARD treatments were continued throughout pregnancy and post-delivery.

Abbreviations: axSpA, axial spondyloarthritis; bDMARD, biologic disease-modifying antirheumatic drug; csDMARD, conventional synthetic disease-modifying antirheumatic drug; HLA-B27, human leukocyte antigen B27; NSAID, non-steroidal anti-inflammatory drug; SD, standard deviation; SpA, spondyloarthritis.

Table 2 Maternal and Fetal Outcomes for Pregnancies with Live Birth

	All Pregnancies n=47	Peripheral SpA n=25	axSpA n=22
Maternal outcomes
Preeclampsia	3 (6%)	0 (0%)	3 (14%)
Gestational diabetes	12 (26%)	4 (16%)	8 (36%)
Gestational hypertension	0 (0%)	0 (0%)	0 (0%)
Delivery mode
NVD	19 (40%)	12 (48%)	7 (32%)
CS (all)	25 (53%)	12 (48%)	13 (59%)
CS (elective)	22 (47%)	10 (40%)	12 (55%)
CS (emergency)	3 (6%)	2 (8%)	1 (5%)
Assisted delivery	3 (6%)	1 (4%)	2 (9%)
Indication for emergency
CS/assisted delivery
Fetal bradycardia	1 (2%)	0 (0%)	1 (5%)
Fetal distress	4 (9%)	3 (12%)	1 (5%)
Prolonged second stage	1 (2%)	0 (0%)	1 (5%)
Live births	47 (100%)	25 (100%)	22 (100%)
Gestational week
<37	3 (6%)	2 (8%)	1 (5%)
37–41	44 (94%)	23 (92%)	21 (95%)
>41	0 (0%)	0 (0%)	0 (0%)
Birth weight (kg)^a	3.04±0.44	3.00±0.35	3.07±0.53
<2.5	4 (9%)	2 (8%)	2 (9%)
2.5–4.0	42 (91%)	22 (92%)	20 (91%)
>4.0	0 (0%)	0 (0%)	0 (0%)
NICU admission	4 (9%)	4 (16%)	0 (0%)
Hypoxia	2 (4%)	2 (8%)	0 (0%)
Sepsis	1 (2%)	1 (4%)	0 (0%)
Distress	1 (2%)	1 (4%)	0 (0%)
Congenital abnormality	1 (2%)	1 (2%)	0 (0%)

Notes: ^aBirth weight data for n=46 owing to missing data for one pregnancy in the peripheral SpA group.

Abbreviations: axSpA, axial spondyloarthritis; CS, cesarean section; NICU, neonatal intensive care unit; NVD, normal vaginal delivery; SpA, spondyloarthritis.

Table 3 Maternal and Fetal Outcomes for Pregnancies with a Live Birth: Sub-Group Analysis of Patients Treated with bDMARD or csDMARD During Pregnancy

	bDMARD^a n=17	csDMARD n=12
Maternal outcomes
Preeclampsia	2 (12%)	0
Gestational diabetes	7 (41%)	2 (17%)
Gestational hypertension	0	0
Delivery mode
NVD	4 (24%)	4 (33%)
CS (all)	11 (65%)	7 (58%)
CS (elective)	11 (65%)	5 (42%)
CS (emergency)	0	2 (17%)
Assisted delivery	2 (12%)	1 (8%)
Live births	16 (100%)	12 (100%)
Gestational week
<37	3 (18%)	0
37–41	14 (82%)	12 (100%)
>41	0	0
Birth weight (kg)
<2.5	2 (12%)	1 (8%)
2.5–4.0	14 (82%)	11 (92%)
>4.0	0	0
NICU admission	3 (18%)	1 (8%)
Hypoxia	2 (12%)	0
Sepsis	1 (6%)	0
Distress	0	1 (8%)
Congenital abnormality	1 (6%)	0

Notes: ^aOne patient received combination therapy with bDMARD and csDMARD. For this analysis, these patients were included in the bDMARD group.

Abbreviations: CS, cesarean section; bDMARD, biologic disease-modifying antirheumatic drug; csDMARD, conventional synthetic disease-modifying antirheumatic drug; NICU, neonatal intensive care unit; NVD, normal vaginal delivery.

Data Sharing Statement

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