Korean J Intern Med.  2021 May;36(3):721-730. 10.3904/kjim.2019.144.

Pregnancy outcomes in Korean women with ankylosing spondylitis

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 2Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 3Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea
  • 4Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background/Aims
Because ankylosing spondylitis (AS) mainly affects sacroiliac joints, special attention should be given to normal labour and pregnancy outcomes. Here, we investigate pregnancy outcomes in Korean women with AS.
Methods
Based on data from the Korean Health Insurance Review and Assessment Service claims database since July 2007, maternal complications were compared between women with AS and 1:10 matched general population by maternal age and year of delivery. Additionally, the 27 deliveries from 21 patients with AS who were seen at a tertiary hospital were retrospectively evaluated using 1:4 matched control group by maternal and gestational age.
Results
In the population-based cohort, there were 1,293 deliveries in 996 patients with AS. Higher maternal age and more comorbidities were reported than in the general population. However, compared to age and delivery-year matched population, only the rate of Caesarean section (CS) was higher in women with AS (odds ratio, 1.52; 95% confidence interval, 1.36 to 1.70). Incidence of other maternal complications was comparable between women with AS and control subjects. In the hospital-based cohort, the CS rate was higher in women with AS (44.4% vs. 20.4%, p = 0.002). Causes of CS was not different in both groups, including previous uterine surgery. There were no significant differences in foetal outcomes, including growth restriction, foetal malformations and Apgar score.
Conclusions
CS deliveries were performed more often in women with AS. However, other maternal complications and offspring complications were similar between women with AS and healthy control subjects.

Keyword

Spondylitis, ankylosing; Pregnancy; Caesarean section
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