{
  "abstract": "Objectives The aim of the study was to assess the contemporary frequency of adverse pregnancy outcomes in women with rheumatoid arthritis (RA) and to identify associated factors.Methods This French prospective multicentre cohort included pregnant women with RA between 2015 and 2021. Maternal characteristics, disease activity, treatments and pregnancy outcomes were analysed. Outcomes of pregnancies in women with RA were compared in univariable analysis with those of matched general population women from the 2016 and 2021 French perinatal surveys assessing maternal and neonatal health. Multivariable logistic regressions were performed to identify factors associated with adverse outcomes.Results A total of 100 pregnancies in 90 women with RA were analysed. Mean maternal age was 33.7±5.0 years and 57.6% were nulliparous. During pregnancy, 46% received glucocorticoids and 39% biologic disease-modifying antirheumatic drugs. Compared with the 359 controls from the general population, preterm birth (OR 2.08, 95% CI 1.04 to 4.09) and small for gestational age (SGA) (OR SGA 10th percentile 2.11, 95% CI 1.12 to 3.94; ORSGA 3rd percentile 3.21, 95% CI 1.13 to 9.44) rates were higher in RA pregnancies. SGA was associated with nulliparity (adjusted OR (aOR) 4.38, 95% CI 1.12 to 9.78), whereas preterm birth was associated with maternal age (aOR 1.14, 95% CI 1.01 to 1.30) and exposure to glucocorticoids at doses ≥10 mg/day during pregnancy (aOR 4.91, 95% CI 1.30 to 10.59).Conclusion In this contemporary cohort mostly followed in tertiary care centres, pregnancies in women with RA remained at increased risk of preterm birth and SGA. Exposure to systemic glucocorticoids at doses ≥10 mg/day emerged as a risk factor for preterm birth, although a contribution of maternal disease activity cannot be entirely excluded.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Department, NOVO Hospital, Pontoise, France"
      ],
      "name": "Sabrina Hamroun"
    },
    {
      "affiliations": [
        "Rheumatology Department, Kremlin-Bicêtre University Hospital, Le Kremlin-Bicêtre, France"
      ],
      "name": "Grégoire Martin de Frémont"
    },
    {
      "affiliations": [
        "Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and Statistics, Paris, France",
        "Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France"
      ],
      "name": "Nathalie Costedoat-Chalumeau"
    },
    {
      "affiliations": [
        "Rheumatology Department, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France",
        "IMOST Team – INSERM (1240), Clermont Auvergne University, Clermont-Ferrand, France"
      ],
      "name": "Marion Couderc"
    },
    {
      "affiliations": [
        "Rheumatology Department, Salengro Hospital, Lille University Hospital, Lille, France"
      ],
      "name": "René-Marc Flipo"
    },
    {
      "affiliations": [
        "INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Team Pepites, Paris, France",
        "AP-HP, Rheumatology Department, Pitié Salpêtrière Hospital, Paris, France"
      ],
      "name": "Laure Gossec"
    },
    {
      "affiliations": [
        "Rheumatology Department, CNRS, Immuno ConcEpT, UMR 5164, Bordeaux University Hospital, and University of Bordeaux, Bordeaux, France"
      ],
      "name": "Christophe Richez"
    },
    {
      "affiliations": [
        "Rheumatology Department, Kremlin-Bicêtre University Hospital, Le Kremlin-Bicêtre, France"
      ],
      "name": "Rakiba Belkhir"
    },
    {
      "affiliations": [
        "Rheumatology Department, Lariboisière University Hospital, Paris, France"
      ],
      "name": "Aline Frazier-Mironer"
    },
    {
      "affiliations": [
        "Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares du Nord-Ouest, CERAINOM, Brest University Hospital, Bres, France"
      ],
      "name": "Valérie Devauchelle-Pensec"
    },
    {
      "affiliations": [
        "CHU Saint-Etienne, INSERM, Mines Saint Etienne, SAINBIOSE U1059, Université Jean Monnet, Service de Rhumatologie, Saint Etienne, France"
      ],
      "name": "Hubert Marotte"
    },
    {
      "affiliations": [
        "Rheumatology Department, CRSA Inserm UMRS8938, Sorbonne University, Saint-Antoine University Hospital, AP-HP centre, Paris, France"
      ],
      "name": "Jérémie Sellam"
    },
    {
      "affiliations": [
        "Rheumatology Department, University Hospital and LITEC UR15560 Poitiers, Poitiers, France"
      ],
      "name": "Elisabeth Gervais"
    },
    {
      "affiliations": [
        "Internal Medicine Department, Grenoble University Hospital, Grenoble, France"
      ],
      "name": "Alban Deroux"
    },
    {
      "affiliations": [
        "Rheumatology Department, Montpellier University Hospital, Montpellier, France"
      ],
      "name": "Cédric Lukas"
    },
    {
      "affiliations": [
        "Rheumatology Department, Le Mans Hospital, Le Mans, France"
      ],
      "name": "Emmanuelle Dernis"
    },
    {
      "affiliations": [
        "Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France"
      ],
      "name": "Véronique Le Guern"
    },
    {
      "affiliations": [
        "Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Paris, France"
      ],
      "name": "Gaëlle Guettrot-Imbert"
    },
    {
      "affiliations": [
        "INSERM Obstetrical Perinatal and Pediatric Epidemiology Research Team, University of Paris, Paris, France"
      ],
      "name": "Nathalie Lelong"
    },
    {
      "affiliations": [
        "Port-Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France"
      ],
      "name": "Emmanuelle Pannier"
    },
    {
      "affiliations": [
        "Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France"
      ],
      "name": "Loïc Sentilhes"
    },
    {
      "affiliations": [
        "Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France",
        "U1153, Centre of Research In Epidemiology and Statistics (CRESS), Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOpé), INSERM, INRAE, Université Paris Cité, Institut Santé des femmes, Paris, France"
      ],
      "name": "Camille Le Ray"
    },
    {
      "affiliations": [
        "Rheumatology Department, Kremlin-Bicêtre University Hospital, Le Kremlin-Bicêtre, France",
        "UVSQ, Inserm CESP U1018, Université Paris-Saclay, Villejuif, France"
      ],
      "name": "Raphaèle Seror"
    },
    {
      "affiliations": [
        "Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and Statistics, Paris, France",
        "Rheumatology Department, Bichat Hospital, AP-HP, Paris, France"
      ],
      "name": "Anna Moltó"
    },
    {
      "affiliations": [],
      "name": "on behalf of the GR2 and the ENP2021 Study Groups"
    }
  ],
  "title": "Evaluation of pregnancy outcomes in patients with rheumatoid arthritis compared with the general population: results from a French national prospective and matched study",
  "uid": "248860e1-286f-5aeb-9561-10d50bb7b4a8"
}