Medication utilisation trends during pregnancy and factors influencing adverse pregnancy outcomes in patients with rheumatoid arthritis
Authors' conclusion
Methotrexate and leflunomide are associated with an increased possibility of APOs, emphasising the importance of appropriate medication adjustment when planning for pregnancy.
Study context
- Population
- Female patients with rheumatoid arthritis (RA) aged 20–50 years, Korean national health insurance database, 2010–2020
- Participants
- 5,728 pregnancy episodes
- Exposure
- Delivery vs adverse pregnancy outcome episodes
- Deliveryn = 4,576reference
- APOn = 1,152
- Outcome
- Factors associated with adverse pregnancy outcomes:
- Abortion
- Stillbirth
Methodological detailsnationwide health insurance database, multivariable logistic regression
- Nationwide health insurance database
- Multivariable logistic regression
Main finding
As reported in the abstract
Factors associated with APOs (multivariable analysis) · within 3 months before conception
MTX use within 3 months before conception, aOR
2.14
95% CI 1.57 to 2.92
LEF use within 3 months before conception, aOR
2.68
95% CI 1.39 to 5.15
Observational data: associations, not effects.
Further findings
Mean maternal age
- Mean maternal age — All pregnancy episodes, mean maternal age (years)
- 33.7
Disease-modifying antirheumatic drug (DMARD) utilisation · preconception and pregnancy
- HCQ most commonly used csDMARD during preconception and pregnancy in both groups
- Prescription rate of all DMARDs decreased rapidly during pregnancy
Original publication
Medication utilisation trends during pregnancy and factors influencing adverse pregnancy outcomes in patients with rheumatoid arthritis. RMD Open. Published 22 March 2024. doi:10.
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