Rebecca Araujo

DocwireNews

Reproductive health outcomes appear to be greatly impacted by the presence of rheumatic diseases, according to a registry study published in <a href="https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keae122/7631296?searchresult=1" target="_blank" rel="noopener">Rheumatology</a>.
“Many studies on reproductive health in [immune-mediated diseases (IMDs)] are characterized by small sample sizes, with less systematic data available on unselected patient populations, few comparative studies across different IMDs, and even fewer looking at both women and men,” the authors wrote. They utilized data from a nationwide registry in Finland to assess the impact of IMDs on reproductive success and adverse maternal and perinatal outcomes in men and women born between 1964 and 1984. Participants who were diagnosed with any IMD before age 30 (women) or 35 (men) were matched to 20 controls by birth year, sex, and education level. The number of children was assessed, as well as data on the mother’s age at delivery, pregnancy-related characteristics and outcomes, and the use of child home-care allowance (mean weeks per child).
The results showed that several rheumatic diseases, particularly systemic lupus erythematosus (SLE), juvenile idiopathic arthritis (JIA), and seropositive rheumatoid arthritis (RA), were associated with participants having higher rates of childlessness or fewer children overall for women. “For many of the diseases in which we observed fewer children, fewer pregnancies were also observed,” the authors noted. The ages of having one’s first and last child were earlier for women with rheumatic diseases and other IMDs compared with controls.  Among men, “seropositive RA, SLE, and JIA were characterized by increased prevalence of childlessness and fewer children,” the authors wrote.
The authors noted that most of the rheumatic diseases studied were associated with an increased risk of preeclampsia, newborns being small for gestational age, preterm delivery, nonelective Caesarean section, and need for neonatal intensive care, with particularly high risks for SLE and Sjögren syndrome. Of the rheumatic diseases, SLE, JIA, RA, and psoriatic arthritis (PsA) were associated with a greater risk of preeclampsia, and PsA was associated with a high risk of gestational hypertension.
“In most rheumatic diseases, moderate (1.1-1.5-fold) risk increases were observed for diverse adverse pregnancy outcomes, with similar effects in [irritable bowel syndrome], celiac disease, asthma, [immune thrombocytopenic purpura], and psoriasis,” the authors noted. They added that the presence of IMDs did not impact the time of returning to the workforce after having a child.
The study was limited to the use of data from the Finnish population, which limits the generalizability outside of countries with similar health care systems. The authors acknowledged they were unable to control for disease-specific factors, such as autoantibodies and disease activity indices. The study was also limited by the use of administrative data for defining IMDs, which can include errors such as incorrect or unspecific coding. The age criteria may also have missed some pregnancies occurring prior to diagnosis.
In summary, “Reproductive success is preserved in many rheumatic diseases, but SLE, JIA, and seropositive RA were associated with a higher incidence of childlessness in both men and women,” the authors wrote. “Considering the widespread impact of rheumatic diseases on reproductive health, our results emphasize the recommendation to discuss family planning early and often in women of reproductive age who have rheumatic diseases and may aid in forming recommendations for pregnancy monitoring in women with rheumatic diseases.” They called for further research to illuminate the role of IMDs on male reproductive health and predictors of adverse pregnancy outcomes in each IMD.

Rob Dillard

Dr. David. G. Amaral on the Role Autism BrainNet Plays in Advancing Autism Research

Neurology

Cecilia Brown

Automated Digital Health Program May Help Overcome Lung Cancer Screening Barriers

Lung Cancer

COVID-19 Infection May Increase the Risk of Heart Attack, Stroke Up to Three Years Later

COVID-19

Latest News

Study Investigates Reproductive Health Outcomes of Patients With Rheumatic Diseases

Rheumatology

Reproductive health outcomes appear to be greatly impacted by the presence of rheumatic diseases.

About Us

Editorial Policy

Advertising

eNewsletters

Contribute

Contact Us

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

Mesothelioma

Non-Small Cell Lung Cancer

Small Cell Lung Cancer

Squamous Cell Lung Carcinoma

Lung Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Diabetes

Ophthalmology

— Demodex Blepharitis

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

The Oncology Brothers

Rheumatology Rounds With Dr. Maheswaranathan

Healthcare Unfiltered

The Fellow on Call

Partners

Career Center

Expert Interviews

Subscribe