Pregnancy outcomes in Korean women with ankylosing spondylitis
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초록
Background/Aims: Because ankylosing spondylitis (AS) mainly affects sacroiliac joints, special attention should be given to normal labour and pregnancy outcomes. Here, we investigate pregnancy outcomes in Korean women with AS. Methods: Based on data from the Korean Health Insurance Review and Assessment Service claims database since July 2007, maternal complications were compared between women with AS and 1:10 matched general population by maternal age and year of delivery. Additionally, the 27 deliveries from 21 patients with AS who were seen at a tertiary hospital were retrospectively evaluated using 1:4 matched control group by maternal and gestational age. Results: In the population-based cohort, there were 1,293 deliveries in 996 patients with AS. Higher maternal age and more comorbidities were reported than in the general population. However, compared to age and delivery-year matched population, only the rate of Caesarean section (CS) was higher in women with AS (odds ratio, 1.52; 95% confidence interval, 1.36 to 1.70). Incidence of other maternal complications was comparable between women with AS and control subjects. In the hospital-based cohort, the CS rate was higher in women with AS (44.4% vs. 20.4%, p = 0.002). Causes of CS was not different in both groups, including previous uterine surgery. There were no significant differences in foetal outcomes, including growth restriction, foetal malformations and Apgar score. Conclusions: CS deliveries were performed more often in women with AS. However, other maternal complications and offspring complications were similar between women with AS and healthy control subjects.
Abstract
Background/Aims: Because ankylosing spondylitis (AS) mainly affects sacroiliac joints, special attention should be given to normal labour and pregnancy outcomes. Here, we investigate pregnancy outcomes in Korean women with AS. Methods: Based on data from the Korean Health Insurance Review and Assessment Service claims database since July 2007, maternal complications were compared between women with AS and 1:10 matched general population by maternal age and year of delivery. Additionally, the 27 deliveries from 21 patients with AS who were seen at a tertiary hospital were retrospectively evaluated using 1:4 matched control group by maternal and gestational age. Results: In the population-based cohort, there were 1,293 deliveries in 996 patients with AS. Higher maternal age and more comorbidities were reported than in the general population. However, compared to age and delivery-year matched population, only the rate of Caesarean section (CS) was higher in women with AS (odds ratio, 1.52; 95% confidence interval, 1.36 to 1.70). Incidence of other maternal complications was comparable between women with AS and control subjects. In the hospital-based cohort, the CS rate was higher in women with AS (44.4% vs. 20.4%, p = 0.002). Causes of CS was not different in both groups, including previous uterine surgery. There were no significant differences in foetal outcomes, including growth restriction, foetal malformations and Apgar score. Conclusions: CS deliveries were performed more often in women with AS. However, other maternal complications and offspring complications were similar between women with AS and healthy control subjects.
참고문헌 (24)
- Exarchou S, "The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations : a nationwide register study", Arthritis Res Ther, 17, pp.118~ (2015)
- Dean LE, "Global prevalence of ankylosing spondylitis", Rheumatology(Oxford), 53, pp.650~657 (2014)
- West HF, "Aetiology of ankylosing spondylitis", Ann Rheum Dis, 8, pp.143~148 (1949)
- Gran JT, "The epidemiology of ankylosing spondylitis", Semin Arthritis Rheum, 22, pp.319~334 (1993)
- Ostensen M, "A prospective study of pregnant patients with rheumatoid arthritis and ankylosing spondylitis using validated clinical instruments", Ann Rheum Dis, 63, pp.1212~1217 (2004)
- Ostensen M, "Ankylosing spondylitis and pregnancy", Rheum Dis Clin North Am, 15, pp.241~254 (1989)
- Jakobsson GL, "Pregnancy outcomes in patients with ankylosing spondylitis : a nationwide register study", Ann Rheum Dis, 75, pp.1838~1842 (2016)
- Nystrom MJ, "Perinatal outcomes among Asian-white interracial couples", Am J Obstet Gynecol, 199, pp.385~ (2008)
- Ruff C, "Body mass prediction from stature and bi-iliac breadth in two high latitude populations, with application to earlier higher latitude humans", J Hum Evol, 48, pp.381~392 (2005)
- Ikoma E, "Quantitative genetic analysis of bi-iliac breadth", Am J Phys Anthropol, 77, pp.295~301 (1988)
- 김지애, "Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data", Journal of Korean Medical Science, 32(5), pp.718~728 (2017), 대한의학회
- van der Linden S, "Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria", Arthritis Rheum, 27, pp.361~368 (1984)
- Eiland E, "Preeclampsia 2012", J Pregnancy, 2012, pp.586578~ (2012)
- Marsal K, "Intrauterine growth curves based on ultrasonically estimated foetal weights", Acta Paediatr, 85, pp.843~848 (1996)
- 이진경, "Percentile Distributions of Birth Weight according to Gestational Ages in Korea (2010-2012)", Journal of Korean Medical Science, 31(6), pp.939~949 (2016), 대한의학회
- American Academy of Pediatrics Committee on Fetus and Newborn, "The Apgar score", Pediatrics, 136, pp.819~822 (2015)
- Timur H, "Pregnancy outcome in patients with ankylosing spondylitis", J Matern Fetal Neonatal Med, 29, pp.2470~2474 (2016)
- Zhou Q, "Management of pregnancy with ankylosing spondylitis", Chin Med Sci J, 27, pp.46~49 (2012)
- Ostensen M, "Ankylosing spondylitis : the female aspect", J Rheumatol, 25, pp.120~124 (1998)
- Torloni MR, "The increasing trend in caesarean section rates : global, regional and national estimates : 1990-2014", PLoS One, 11, pp.e0148343~ (2016)
- 정성훈, "Changes in the Cesarean Section Rate in Korea (1982–2012) and a Review of the Associated Factors", Journal of Korean Medical Science, 29(10), pp.1341~1352 (2014), 대한의학회
- OECD, "Health at a Glance 2017" (2017), OECD Publishing
- "Rheumatoid arthritis and pregnancy" (2019)[URL]
- Hamilton BE, "Births : final data for 2014", Natl Vital Stat Rep, 64, pp.1~64 (2015)