Pregnancy Outcomes in Patients With Adult-Onset Still's Disease: A Cohort Study From China

Frontiers in Medicine

article

Zhihong Wang¹  Hui Shi¹  Yue Sun¹  Qiongyi Hu¹  Jinchao Jia¹  Tingting Liu¹  Liyan Wan¹  Xinyao Wu¹  Zhuochao Zhou¹  Chengde Yang¹  Yutong Su¹  Huihui Chi¹  Tienan Feng²  Qinwen Du³  Ting Zeng⁴  Jialin Teng¹  Honglei Liu¹  Xiaobing Cheng¹  Junna Ye¹ 

[1] Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Hongqiao International Institute of Medicine, Shanghai Tongren Hospital/Clinical Research Institute, Shanghai Jiao Tong University School of Medicine;Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Department of Rheumatology, Xinhua Hospital Chongming Branch Affiliated to Shanghai Jiao Tong University School of Medicine

关键词: pregnancy;    outcome;    generalized linear mixed effect model;    adverse impact;    adult-onset still's disease;   

DOI  :  10.3389/fmed.2020.566738

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective: Adult-onset Still's disease (AOSD) is an autoinflammatory disease with a higher prevalence rate in young females. The purpose of this study is to investigate whether AOSD has an adverse impact on pregnancy outcomes, or conversely exacerbated by pregnancy. Methods: The outcomes of 191 pregnancies were evaluated in 86 female patients with AOSD. The generalized linear mixed model and propensity score matching method were conducted to evaluate the influence of AOSD on pregnancy outcomes. A dependent sample sign test was applied to assess the impact of pregnancy on the relapse of AOSD. Results: The results showed that the post-AOSD group had a lower proportion of normal delivery (25.0 vs. 52.4%, p = 0.036) and a higher proportion of spontaneous abortion (STA) (18.8 vs. 0.6%, p = 0.002) compared with the pre-AOSD group. Moreover, pregnancy after being diagnosed with AOSD was a significant high risk factor of STA (adjusted OR = 4.577, 95% CI: 4.166–845.119; p = 0.003). Disease flare upon conception was observed in one of 16 post-AOSD pregnancies ( p = 1.000). There were 11 patients with new-onset AOSD during gestation or postpartum, among which five (45.4%) evolved into the polycyclic course. Conclusions: AOSD patients might suffer from a higher risk of STA, however, pregnancy might not be related with the exacerbation of diagnosed AOSD. New-onset AOSD during gestation or postpartum tend to evolve into the polycyclic course.

【 授权许可】

CC BY