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Ankylosing spondylitis--the female aspect
1Department of Rheumatology, University Hospital, Trondheim, Norway.
The Journal of Rheumatology
|February 11, 1998
Summary
Ankylosing spondylitis (AS) does not negatively impact fertility or pregnancy outcomes. Disease improvement during pregnancy is linked to peripheral arthritis and a female fetus, while active AS at conception predicts postpartum flares.
Area of Science:
- Rheumatology
- Obstetrics and Gynecology
- Reproductive Health
Background:
- Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting the spine.
- Understanding the impact of AS on female reproductive health is crucial for patient management.
Purpose of the Study:
- To investigate the reproductive performance of women with ankylosing spondylitis.
- To examine the interaction between AS and pregnancy in a large patient cohort.
Main Methods:
- A questionnaire study was conducted in collaboration with the Ankylosing Spondylitis International Federation.
- Data on clinical features and pregnancy details were collected from female AS society members across North America and Europe.
Main Results:
- Onset of AS was pregnancy-related in 21% of cases; common features included peripheral arthritis (45%) and acute anterior uveitis (48%).
- Pregnancy outcomes were generally favorable, with 15.1% miscarriage rate and 93.2% delivery at term.
- Disease activity remained stable in 33.2%, improved in 30.9%, and worsened in 32.5% of pregnancies; improvement correlated with peripheral arthritis and female fetus.
- Postpartum flares occurred in 60% of patients, particularly those with active disease at conception.
Conclusions:
- Ankylosing spondylitis does not adversely affect fertility or pregnancy outcomes.
- Improvement during pregnancy is associated with peripheral arthritis and a female fetus.
- Active AS at conception is a predictor for postpartum flares.