Women's Health

March 28, 2022

Rheumatoid arthritis: special deliveries

Birth outcomes including postpartum infection and blood transfusion were similar in women with and without rheumatoid arthritis, and continued use of disease-modifying antirheumatic drugs and biologics is recommended to limit steroid exposure.

by Bill Snyder

Studies on birth outcomes among women with rheumatoid arthritis (RA) are limited and conflicting.

To help fill the gap, April Barnado, MD, MSCI, and colleagues evaluated postpartum outcomes detailed in the electronic health records of 202 women with RA, compared to 596 women without autoimmune diseases who served as controls. 

Reflecting previous findings, the researchers reported that women with RA had an increased risk for preterm birth. However, rates of postpartum maternal infections and red blood cell transfusions were not significantly increased in the RA group compared to controls. 

On the other hand, use of corticosteroids at delivery increased the risk of postpartum maternal infections and lower birthweight babies, while treatment with another class of RA drugs, TNF inhibitors, did not. 

Reporting in the journal  Seminars in Arthritis and Rheumatism, the researchers concluded that health care providers may need to encourage continued use ofdisease-modifying antirheumatic drugs and biologics, like anti-TNF agents, to limit corticosteroid exposure during pregnancy.

NIThe research was supported by National Institutes of Health grants AR072757, RR024975 and TR000445, and the Rheumatology Research Foundation.