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Is Disease Activity in Rheumatoid Arthritis during Pregnancy and after Delivery Predictive for Disease Activity in a
Hilal Ince-Askan1, Johanna M W Hazes2, Radboud J E M Dolhain2
1From the Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands.H. Ince-Askan, MD, Department of Rheumatology, Erasmus Medical Center; J.M. Hazes, MD, PhD, Department of Rheumatology, Erasmus Medical Center; R.J. Dolhain, MD, PhD, Department of Rheumatology, Erasmus Medical Center. h.ince-askan@erasmusmc.nl.
Objective:
To determine whether disease activity in women with rheumatoid arthritis (RA) in 1 pregnancy is predictive for disease activity in a subsequent pregnancy.
Methods:
In the Pregnancy-induced Amelioration of Rheumatoid Arthritis study, there are prospective data on 27 patients who participated twice. Improvement and deterioration is determined by changes in the Disease Activity Score in 28 joints.
Results:
Only 4 patients (14.8%) had comparable disease courses in both pregnancies, whereas treatment remained mostly similar. In contrast, a flare postpartum after the first pregnancy was predictive for a flare after the second pregnancy (p = 0.003).
Conclusion:
RA disease course in following pregnancies cannot be predicted based upon previous pregnancies. However, a flare postpartum seems to predict subsequent flares.
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