Heart Disease, Hypertension, Gestational Diabetes Mellitus, and Preeclampsia/Eclampsia in Mothers With Juvenile Arthritis: A Nested Case–Control Study

Feldman, Debbie Ehrmann; Vinet, Évelyne; Bérard, Anick; Duffy, Ciarán M.; Hazel, Beth; Meshefedjian, Garbis; Sylvestre, Marie‐Pierre; Bernatsky, Sasha

doi:10.1002/acr.22925

Cited by 10 publications

(7 citation statements)

References 15 publications

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“…Even though most authors describe an increased risk of pre-eclampsia in JIA pregnancies compared to the general population, our observation has been reported also by others. 2,5,6,9,27 Caesarean section was very common in our JIA patients, with a probability of 67.6%. This figure was significantly higher than both healthy and disease controls, and might be partially explained by concerns about parturition stress on hip prosthesis.…”

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

“…C-section was reported as the preferred birth modality in JIA back in 1991; however, the rate of caesareans in our cohort is to date the highest described: in previous literature, caesarean sections were performed from 8.6% to 51% of cases. 1 , 2 , 5 , 6 , 8 – 10 , 27 In this regard, it should be highlighted that the rate of caesarean section in Italian general population is 38%. 28 …”

Section: Discussionmentioning

confidence: 99%

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Pregnancy in juvenile idiopathic arthritis: maternal and foetal outcome, and impact on disease activity

Gerosa

Chighizola

Pregnolato

et al. 2022

Therapeutic Advances in Musculoskeletal

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Objective: This retrospective cohort study describes the modulation of disease activity during gestation and in the year following delivery as well as maternal and neonatal outcomes in a monocentric cohort of women with juvenile idiopathic arthritis (JIA). Methods: Disease activity was assessed using DAS28-CRP before conception and every 3 months during pregnancy and in the first year postpartum. The risk of complicated pregnancies was measured applying a generalized estimating equation model. Changes in disease activity during gestation and in the first year postpartum were assessed in a linear mixed model for repeated measures. Results: Thirty-one women (49 pregnancies) with persisting JIA and at least one conception were enrolled. Adjusted DAS28-CRP levels remained stable from preconception through the first trimester, but increased significantly in the second and decreased not significantly in the third. In the postpartum, adjusted disease activity peaked at 3 months after delivery, stabilized at 6 months to decrease at 1 year, although not significantly. Preconceptional DAS28-CRP and number of biological drugs predicted disease activity fluctuation during gestation. The number of biological drugs and the length of gestational exposure to biologics significantly predicted pregnancy morbidity. In particular, JIA women had a higher probability of preterm delivery compared with healthy and disease controls. Adjusted for breastfeeding and DAS28-CRP score in the third trimester, postconceptional exposure to biologics was inversely related with disease activity in the postpartum: the longer the patient continued treatment, the lower the probability of experiencing an adverse pregnancy outcome. Conclusion: These data offer novel insights on how treatment affects disease activity during pregnancy and postpartum as well as obstetric outcomes in women with JIA.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pregnancy in juvenile idiopathic arthritis: maternal and foetal outcome, and impact on disease activity

Gerosa

Chighizola

Pregnolato

et al. 2022

Therapeutic Advances in Musculoskeletal

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“…This potentially influential role of education is important given our respondents' desire to learn more about specific topics and their lack of confidence in existing privacy and security procedures. To address these needs, we recommend showcasing Canadian studies in which administrative data were used to assess complications [40][41][42] and long-term effects [43][44][45][46] of medications in patients with chronic diseases. Furthermore, it is essential to provide more information about the role of data stewards in adjudicating data requests and imposing conditions to data access.…”

Section: Discussionmentioning

confidence: 99%

Canadians’ views on the use of routinely collected data in health research: a patient-oriented cross-sectional survey

McCormick

Hamilton

Koehn

et al. 2019

cmajo

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Plain language summary: Every day, information is collected about how Canadians use publicly funded health care. The information collected is stored in large electronic data sets. Studying these data can teach us about the quality of our health care, help patients and improve government spending on health care. For example, some data sets can show long-term effects of a given type of treatment. This is not commonly known from single research studies involving small numbers of patients. It is not clear how much Canadians know about these data sets and how researchers can use them. This study surveyed adult Canadians on their views on using such data sets to do health research. The study was done in partnership between university researchers and 3 patients representing national arthritis and skin disease groups. Together, they wrote and tested an online survey, found participants, and interpreted and shared what they learned from the study. Most people who finished the survey agreed with using large data sets to do health research, especially after they read background information on their value. The respondents said the best uses were shown when researchers studied long-term effects in large numbers of people. They felt names and personal information should not be shown. They wished to learn more about how researchers are given access to data sets, and, at the end of survey, they still felt unsure about how privacy and security are ensured. In conclusion, providing information to the public on the use of large sets of health data may increase support for this type of health research. A nalyses of data collected routinely by provincial health ministries and other public bodies 1 can inform health policy-making 2 and advance our knowledge of the burden 3 and risks 4 of diseases, the clinical effectiveness 5 and cost-effectiveness 6 of treatments, and drivers of health care costs. 7 Health researchers in Canada can access a growing array of publicly collected data on the use

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“…prevalence of metabolic syndrome is increased in adults with a history of arthritis (6). A study of women of childbearing potential showed that women with a history of arthritis had a higher risk of heart disease compared to those without arthritis (13). To our knowledge, our study is the first to evaluate the risk of CAD in adults with a history of JA regardless of sex or race.…”

Section: Discussionmentioning

confidence: 80%

Coronary Artery Disease in Adults With a History of Juvenile Arthritis

Sule

Fontaine

2020

Arthritis Care & Research

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Objective. To define the risk of coronary artery disease (CAD) in adults with a history of juvenile arthritis (JA). Methods. We used the National Health and Nutrition Examination 2007-2014 surveys. Two comparison groups were identified: a random sample of patients without arthritis, and respondents who reported having rheumatoid arthritis (RA). CAD was defined as a "yes" response to the survey question, "Have you ever been told you had congestive heart failure, coronary heart disease, angina/angina pectoris, heart attack, or stroke?" Potential confounders for CAD included age, sex, race, smoking status, and any component of metabolic syndrome. Results. A total of 232 respondents reported having JA. We randomly selected 1,028 without arthritis and 1,105 who reported having RA. In simple logistic regression, the JA group had a 3-fold increased odds of CAD compared to those without arthritis (odds ratio [OR] 3.2 [95% confidence interval (95% CI) 2.1-4.8], P < 0.0001). Controlling for confounders, the odds of CAD in JA continued to be increased (OR 4.2 [95% CI 4.7-10.5], P = 0.002). When comparing the JA and RA groups, in simple logistic regression, the JA group had a lower odds of CAD (OR 0.7 [95% CI 0.5-0.9], P = 0.03). Controlling for confounders, there was no significant difference in the odds of CAD between groups (OR 0.8 [95% CI 0.5-1.3], P = 0.4). Conclusion. Adults with a history of JA have a higher risk of CAD compared to adults without arthritis. Providers should be aware of the increased risk of CAD in adults with JA and aggressively screen these patients for modifiable risk factors.

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Heart Disease, Hypertension, Gestational Diabetes Mellitus, and Preeclampsia/Eclampsia in Mothers With Juvenile Arthritis: A Nested Case–Control Study

Cited by 10 publications

References 15 publications

Pregnancy in juvenile idiopathic arthritis: maternal and foetal outcome, and impact on disease activity

Pregnancy in juvenile idiopathic arthritis: maternal and foetal outcome, and impact on disease activity

Canadians’ views on the use of routinely collected data in health research: a patient-oriented cross-sectional survey

Coronary Artery Disease in Adults With a History of Juvenile Arthritis

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