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Association between maternal rheumatoid arthritis and small for gestational age neonates: a systematic review and

Lv Tian1,2, Zhiyuan Zhang2, Yuting Mao3

  • 1Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.

Frontiers in Public Health
|September 25, 2023
PubMed

Insights

Maternal rheumatoid arthritis (RA) significantly increases the risk of offspring developing small for gestational age (SGA). This systematic review confirms the association, highlighting the need for further research into underlying mechanisms.

Area of Science:

  • Obstetrics and Gynecology
  • Rheumatology
  • Perinatal Medicine

Background:

  • Maternal rheumatoid arthritis (RA) is a potential risk factor for small for gestational age (SGA) offspring.
  • Previous studies suggested an association, but lacked statistical significance.
  • Clarifying the maternal RA-SGA link is vital for identifying adverse pregnancy outcomes and interventions.

Approach:

  • A systematic literature search identified eligible studies up to August 2022.
  • Quality assessment utilized the Newcastle-Ottawa scale, with heterogeneity assessed via Q and I² tests.
  • Meta-analysis calculated Odds Ratios (ORs) with 95% Confidence Intervals (CIs), employing random or fixed effects models.

Key Points:

  • Seven studies encompassing 12,323,918 participants were analyzed.
  • A statistically significant association was found between maternal RA and SGA (OR = 1.70, 95% CI = 1.29-2.23, p < 0.001).
  • Sensitivity analyses confirmed stable results, and publication bias was assessed as absent.

Conclusions:

  • Maternal RA is definitively linked to an elevated risk of SGA in offspring.
  • Further research is required to elucidate the specific biological mechanisms connecting maternal RA and SGA.
Abstract

Keywords:
maternal rheumatoid arthritismeta-analysisrheumatoid arthritissmall for gestational agesystematic review

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