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Does Rheumatoid Arthritis Really Improve During Pregnancy? A Systematic Review and Metaanalysis
Hannah Jethwa1,2, Suzanne Lam3,4, Colette Smith3,4
1From the Rheumatology Department, London North West Healthcare National Health Service (NHS) Trust; General Medicine, Croydon University Hospital; Statistics Department, Royal Free Hospital; Centre for Rheumatology Research, Rayne Institute, University College London, London, UK. hannahjethwa@nhs.net.
Objective:
We performed a systematic review and metaanalysis to assess rheumatoid arthritis (RA) disease activity during pregnancy using objective disease activity scoring systems.
Methods:
A systematic review of PubMed, EMBASE/Medline, Cochrane, and LactMed databases was performed. Our inclusion criteria for analysis were prospective studies, more than 5 patients per study, and data on RA using an objective scoring system conducted by a clinician/health professional.
Results:
Ten studies were eligible for final analysis, which included 237 patients, of which prepartum data were available for 204 patients. Postpartum disease activity was recorded in 135 pregnancies.
Conclusion:
Disease activity improved in 60% of patients with RA in pregnancy and flared in 46.7% postpartum.
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