In pregnancy, several changes in the immune system take place which in turn affects the course of rheumatoid arthritis (RA). Hissay Aljary et al. evaluated in their cohort study that pregnant women are at a greater plausibility of adverse maternal and neonatal outcomes and they should also be made well-informed of these risks.

The current study aimed to estimate if there is a greater risk of adverse maternal and neonatal outcomes in pregnant women suffering from RA.

Healthcare Cost and Utilization Project – National Inpatient Sample (HCUP-NIS), USA was utilized for this retrospective cohort study. All births that took place between 2004-2013 were recognised. ICD-9 coding was used for classifying RA in women. The adjusted effect of RA on neonatal and maternal outcomes were estimated using unconditional logistic regression.

Of the total 8,417,607 births, 6068 were among women suffering from RA for an overall incidence of 72 per 100,000 births. Over the 10-year duration of study, a stable increase in reported RA in pregnancy from 47 to 100 per 100,000 was noted. Women with RA were more likely to initiate pre-eclampsia/eclampsia, gestational diabetes, to present with preterm premature rupture of membranes (PPROM), to experience placental abruption and placenta previa, and to deliver by caesarean section. Wound difficulties and thromboembolisms were associated with postpartum, RA-complicated pregnancies. Congenital anomalies, small for gestational age and preterm birth were more frequent in neonates of women with RA.

There is a higher risk of adverse maternal and neonatal outcomes in pregnant women with RA. The risks should be well informed to these women.