Rheumatoid Arthritis-associated Complications During Pregnancy and Its Effect on Offspring: Comprehensive Review

Overview

Journal Inflammopharmacology

Specialty Pharmacology

Date 2024 May 1

PMID 38691248

Authors

S Rohini

Uday Raj Sharma

M Vinutha

D Shreelaxmi

Surendra Vada

Suresh Janandri

T Haribabu

Nageena Taj

S V Gayathri

Abhishek Ghara

Manjunatha P Mudagal

Affiliations

Soon will be listed here.

Abstract

This study comprehensively explores the complexities of rheumatoid arthritis during pregnancy and its impact on offspring. Through an extensive review of existing literature, we investigate maternal and fetal risks, including adverse pregnancy outcomes and developmental issues in offspring. Utilizing reputable databases such as PubMed, Google Scholar, and Science Direct, we meticulously examined studies exploring the connection between rheumatoid arthritis and pregnancy complications, with a focus on outcomes for offspring. We excluded studies lacking sufficient data or peer review. Synthesizing findings from selected studies, we identified common themes and patterns, presenting results in a clear, organized manner. Our examination reveals a heightened likelihood of preterm birth and preeclampsia among pregnant individuals with rheumatoid arthritis, often correlated with disease activity. Furthermore, we highlight the impact on fetal and neonatal outcomes, such as low birth weight, underscoring the importance of meticulous disease management throughout pregnancy. Balancing the necessity of disease-modifying agents with potential risks, and consideration of medication safety is paramount. A multidisciplinary approach involving rheumatologists and obstetricians is crucial for optimizing outcomes. In conclusion, this synthesis underscores the nuanced challenges of rheumatoid arthritis in pregnancy. A comprehensive understanding and personalized, multidisciplinary approach to an organization is essential for informed decision-making in clinical practice. Our review contributes to ongoing discourse, providing insights for enhanced patient care and guiding future research endeavors.

References

Antonucci R, Zaffanello M, Puxeddu E, Porcella A, Cuzzolin L, Pilloni M . Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn. Curr Drug Metab. 2012; 13(4):474-90. DOI: 10.2174/138920012800166607. View

Baerts W, Fetter W, Hop W, Wallenburg H, Spritzer R, Sauer P . Cerebral lesions in preterm infants after tocolytic indomethacin. Dev Med Child Neurol. 1990; 32(10):910-8. DOI: 10.1111/j.1469-8749.1990.tb08104.x. View

Banhidy F, Acs N, Puho E, Czeizel A . Chronic hypertension with related drug treatment of pregnant women and congenital abnormalities in their offspring: a population-based study. Hypertens Res. 2010; 34(2):257-63. DOI: 10.1038/hr.2010.227. View

Barrett J, Brennan P, Fiddler M, Silman A . Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. Arthritis Rheum. 1999; 42(6):1219-27. DOI: 10.1002/1529-0131(199906)42:6<1219::AID-ANR19>3.0.CO;2-G. View

Bharti B, Lee S, Lindsay S, Wingard D, Jones K, Lemus H . Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. J Rheumatol. 2015; 42(8):1376-82. DOI: 10.3899/jrheum.140583. View

Borrero C, Mountz J, Mountz J . Emerging MRI methods in rheumatoid arthritis. Nat Rev Rheumatol. 2010; 7(2):85-95. DOI: 10.1038/nrrheum.2010.173. View

Bowden A, Barrett J, Fallow W, Silman A . Women with inflammatory polyarthritis have babies of lower birth weight. J Rheumatol. 2001; 28(2):355-9. View

Broms G, Granath F, Ekbom A, Hellgren K, Pedersen L, Sorensen H . Low Risk of Birth Defects for Infants Whose Mothers Are Treated With Anti-Tumor Necrosis Factor Agents During Pregnancy. Clin Gastroenterol Hepatol. 2015; 14(2):234-41.e1-5. DOI: 10.1016/j.cgh.2015.08.039. View

Burmester G, Waters S, Winchester R . Identification of three major synovial lining cell populations by monoclonal antibodies directed to Ia antigens and antigens associated with monocytes/macrophages and fibroblasts. Scand J Immunol. 1983; 17(1):69-82. DOI: 10.1111/j.1365-3083.1983.tb00767.x. View

10.

Carmichael S, Shaw G . Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genet. 1999; 86(3):242-4. DOI: 10.1002/(sici)1096-8628(19990917)86:3<242::aid-ajmg9>3.0.co;2-u. View

11.

Carter J, Ladhani A, Ricca L, Valeriano J, Vasey F . A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database. J Rheumatol. 2009; 36(3):635-41. DOI: 10.3899/jrheum.080545. View

12.

Cassina M, Johnson D, Robinson L, Braddock S, Xu R, Jimenez J . Pregnancy outcome in women exposed to leflunomide before or during pregnancy. Arthritis Rheum. 2012; 64(7):2085-94. DOI: 10.1002/art.34419. View

13.

Chakravarty E . Rheumatoid arthritis and pregnancy: beyond smaller and preterm babies. Arthritis Rheum. 2011; 63(6):1469-71. DOI: 10.1002/art.30206. View

14.

Chakravarty E, Nelson L, Krishnan E . Obstetric hospitalizations in the United States for women with systemic lupus erythematosus and rheumatoid arthritis. Arthritis Rheum. 2006; 54(3):899-907. DOI: 10.1002/art.21663. View

15.

Dawood M . Nonsteroidal antiinflammatory drugs and reproduction. Am J Obstet Gynecol. 1993; 169(5):1255-65. DOI: 10.1016/0002-9378(93)90292-q. View

16.

de Man Y, Bakker-Jonges L, Goorbergh C, Tillemans S, Hooijkaas H, Hazes J . Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy. Ann Rheum Dis. 2009; 69(2):420-3. DOI: 10.1136/ard.2008.104331. View

17.

de Man Y, Hazes J, van der Heide H, Willemsen S, de Groot C, Steegers E . Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum. 2009; 60(11):3196-206. DOI: 10.1002/art.24914. View

18.

de Steenwinkel F, Hokken-Koelega A, de Man Y, de Rijke Y, de Ridder M, Hazes J . Circulating maternal cytokines influence fetal growth in pregnant women with rheumatoid arthritis. Ann Rheum Dis. 2012; 72(12):1995-2001. DOI: 10.1136/annrheumdis-2012-202539. View

19.

de Steenwinkel F, Hokken-Koelega A, de Ridder M, Hazes J, Dolhain R . Rheumatoid arthritis during pregnancy and postnatal catch-up growth in the offspring. Arthritis Rheumatol. 2014; 66(7):1705-11. DOI: 10.1002/art.38519. View

20.

Dedmon L . The genetics of rheumatoid arthritis. Rheumatology (Oxford). 2020; 59(10):2661-2670. DOI: 10.1093/rheumatology/keaa232. View