Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients

Stephanie van den Brandt; Astrid Zbinden; Dominique Baeten; Peter M. Villiger; Monika Østensen; Frauke Förger

doi:10.1186/s13075-017-1269-1

Table 3 Risk factors for flare during the course of pregnancy

From: Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients

	Patients with RA (n = 75)					Patients with axSpA (n = 61)
	Flare	No flare	RR	95% CI	P value	Flare	No flare	RR	95% CI	P value
Treatment
TNFi before pregnancy^a and discontinued at positive pregnancy test	10 of 22 (45.5)	5 of 53 (9.4)	3.333	(1.8–6.1)	0.001*	10 of 15 (66.7)	14 of 46 (30.4)	3.083	(1.2–7.9)	0.017*
TNFi during first trimester	3 of 22 (13.6)	5 of 53 (9.4)	1.322	(0.5–3.5)	0.686	6 of 15 (40)	12 of 46 (26.1)	1.593	(0.7–3.8)	0.340
GCs before pregnancy	8 of 22 (36.4)	17 of 53 (32.1)	1.143	(0.6–2.4)	0.790	1 of 15 (6.7)	4 of 46 (8.7)	0.800	(0.1–4.9)	0.642
GCs during first trimester	8 of 22 (36.4)	17 of 53 (32.1)	1.143	(0.6–2.4)	0.790	1 of 15 (6.7)	6 of 46 (13)	0.551	(0.1–3.6)	0.178
DMARDs before pregnancy	10 of 22 (45.5)	22 of 53 (41.5)	1.120	(0.6–2.3)	0.801	3 of 15 (20)	5 of 46 (10.9)	1.656	(0.6–4.6)	0.589
DMARDs during first trimester	8 of 22 (36.4)	22 of 53 (42.5)	0.860	(0.4–1.8)	0.798	2 of 15 (13.3)	3 of 46 (6.5)	1.723	(0.5–5.6)	0.589
NSAIDs before pregnancy	2 of 22 (9.1)	6 of 53 (11.3)	0.838	(0.2–2.9)	0.568	3 of 15 (20)	15 of 46 (32.6)	0.597	(0.2–1.9)	0.518
NSAIDs during first trimester	3 of 22 (13.6)	6 of 53 (11.3)	1.158	(0.4–3.1)	0.716	3 of 15 (20)	15 of 46 (32.6)	0.597	(0.2–1.9)	0.518
Disease activity
Active disease before pregnancy^a	5 of 22 (22.7)	9 of 53 (17.0)	1.282	(0.6–2.9)	0.536	2 of 15 (13.3)	4 of 46 (8.7)	1.410	(0.4–4.8)	0.630
Active disease during first trimester	8 of 22 (36.4)	10 of 53 (18.9)	0.456	(0.2–0.9)	0.038*	5 of 15 (33.3)	11 of 46 (23.9)	0.717	(0.3–1.7)	0.510
Elevated CRP before pregnancy^a	3 of 22 (13.6)	8 of 53 (15.1)	0.584	(0.3–1.3)	0.282	1 of 15 (6.7)	2 of 46 (4.3)	0.724	(0.1–3.8)	0.718
Elevated CRP during first trimester	9 of 22 (40.9)	12 of 53 (22.6)	0.553	(0.2–0.7)	0.008*	7 of 15 (46.7)	6 of 46 (13)	0.280	(0.1–0.7)	0.006*

Abbreviations: axSpA Axial spondyloarthritis, CRP C-reactive protein, DMARD Disease-modifying antirheumatic drug, GC Glucocorticosteroid, NSAID Nonsteroidal anti-inflammatory drug, RA Rheumatoid arthritis, RR Relative risk, SpA Spondyloarthritis, TNFi Tumor necrosis factor inhibitor
^a“Before pregnancy” refers to period from 20 weeks prior to conception until the positive pregnancy test
* p <0.05

Back to article page