Causal Association of Rheumatoid Arthritis With Adverse Pregnancy Outcomes: Genetic Evidence From Mendelian...

Area of Science:

• Reproductive Health
• Immunology
• Genetics

Background:

• Rheumatoid arthritis (RA) is associated with adverse pregnancy outcomes, but the role of serum antibody levels remains unclear.
• Understanding these associations is crucial for managing RA during pregnancy.

Purpose of the Study:

• To investigate the causal impact of RA, serologic antibody-positive RA (pRA), and serologic antibody-negative RA (nRA) on 14 adverse pregnancy outcomes.
• To provide evidence for individualized treatment strategies in pregnant RA patients.

Main Methods:

• Two-sample Mendelian randomization (MR) analysis was employed.
• Data from UK Biobank and FinnGen databases were utilized.
• Inverse variance weighted (IVW) method and MR-PRESSO package were used for robust causal inference.

Main Results:

• RA showed causal associations with cesarean section, gestational hypertension, spontaneous miscarriages, preeclampsia, premature rupture of membranes, and preterm birth.
• pRA was causally linked to cesarean section, gestational hypertension, preeclampsia, and preterm birth.
• nRA was causally associated with gestational hypertension, spontaneous miscarriages, placental abruption, and negatively with birth weight.

Conclusions:

• RA, pRA, and nRA have distinct causal impacts on specific adverse pregnancy outcomes.
• Findings support personalized management of RA in pregnancy, particularly for those with positive serum antibody levels.