• Marianne Wallenius, Kjell Å Salvesen, Anne K Daltveit, and Johan F Skomsvoll.
• National Service for Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
• Acta Obstet Gynecol Scand. 2014 Mar 1; 93 (3): 302-7.

ObjectiveTo examine associations between rheumatoid arthritis (RA) and pregnancy outcomes in first and subsequent births.DesignCohort study.SettingStudy based on data registered in the Medical Birth Registry of Norway from the period 1 December 1998 to 31 December 2009.PopulationSingleton births in women recorded with RA (n = 1496) and reference deliveries from the general population (n = 625,642).MethodsOutcomes of first and subsequent births were analyzed separately. First birth was defined as the first delivery of nulliparous women. Associations between RA and maternal and perinatal outcomes were assessed in logistic regression analyses and adjusted for maternal age at delivery, gestational age, smoking habits and for previous cesarean section when relevant.Main Outcome MeasuresMaternal and perinatal outcomes.ResultsVaginal bleeding was observed more often among women with RA both in first pregnancy [adjusted odds ratio (aOR) 1.8, 95% CI 1.3-2.4] and in subsequent pregnancies (aOR 1.4, 95% CI 1.1-1.9). Elective cesarean section was more common among women with RA both in the first birth (aOR 2.0, 95% CI 1.4-2.8) and in subsequent births (aOR 1.5, 95% CI 1.2-2.0). Preterm delivery was more frequent among women with RA than the reference population in first pregnancy (aOR 1.5, 95% CI 1.1-2.0) and in subsequent pregnancies (aOR 1.5, 95% CI 1.1-1.9).ConclusionComplications and poor pregnancy outcomes were more often observed in women with RA and the greatest differences were observed in the first pregnancy.© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

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