胎儿生长与母亲类风湿性关节炎和青少年类异常性关节炎相关
Eugenia Yupei Chock1, Bente Glintborg2,3, Zeyan Liew4
1Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, 300 Cedar Street, New Haven, CT 06520, USA.
Healthcare (Basel, Switzerland)
|December 17, 2024
概括
患有类风湿性关节炎 (RA) 和青少年异常性关节炎 (JIA) 的孕妇患者面临更高的妊娠不良结果风险. 在RA和JIA怀孕中,胎儿生长受限似乎发生在妊娠22周后,特别是在使用皮质类固醇或硫法萨拉时.
科学领域:
- 产科和妇科 产科和妇科
- 类风湿病学 类风湿病学
- 儿科 儿科 儿科
背景情况:
- 患有类风湿性关节炎 (RA) 和青少年异常性关节炎 (JIA) 的患者患不良妊娠后果的风险增加了两倍.
- 在受RA和JIA影响的怀孕中评估胎儿生长对于了解发育轨迹至关重要.
研究的目的:
- 评估和比较RA和JIA怀孕和没有怀孕之间的胎儿生长模式.
- 在RA和JIA患者中确定妊娠期间对胎儿发育的特定脆弱期.
主要方法:
- 丹麦 (2008-2018) 基于人口的队列研究,包括503,491例单独怀孕.
- 连接全国数据库以识别RA/JIA患者,并从第二个三个月的超声波和出生体重获得胎儿生物识别数据.
- 计算的胎儿生长梯度和妊娠年龄相对小的风险 (SGA),调整为混因素.
主要成果:
- 母亲的RA和JIA与第二个三个月的胎儿估计体重 (EFW) 降低无关.
- 在使用皮质类固醇或硫法萨拉的RA/JIA患者中,从第二个三个月到出生时,观察到胎儿体重增加的减少.
- RA和JIA与SGA的风险增加有关,对皮质类固醇和硫法萨拉使用者来说风险更高.
结论:
- 在RA和JIA怀孕中,胎儿生长受限可能发生在妊娠18-22周后.
- 怀孕的下半年是RA和JIA患者胎儿生长的关键时期.
- 药物使用,特别是皮质类固醇和硫沙拉,在这些怀孕中影响胎儿生长轨迹.
关键词:
自身免疫性疾病是一种自身免疫性疾病.胎儿的成长 胎儿的成长高风险的怀孕高风险的怀孕青少年异常性关节炎 (Idiopathic Arthritis) 是一种疾病.孕产妇的胎儿医学类风湿性关节炎 类风湿性关节炎更多相关视频
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