RESEARCH - Does RA remit during pregnancy and relapse postpartum?

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Arthritis & Rheumatism

Volume 42, Issue 6 , Pages 1219 - 1227

Published Online: 26 Apr 2001

Does rheumatoid arthritis remit during pregnancy and relapse

postpartum?: Results from a nationwide study in the United Kingdom performed

prospectively from late pregnancy

H. Barrett *, Brennan, Magdalen Fiddler, Alan J. Silman

University of Manchester, Manchester, UK

*Correspondence to H. Barrett, Arthritis Research Campaign

Epidemiology Unit, University of Manchester, Stopford Building, Oxford Road,

Manchester, M13 9PT, UK

Abstract

Objective

To ascertain the influence of pregnancy on disease activity in women

with rheumatoid arthritis (RA) during pregnancy and postpartum.

Methods

One hundred forty pregnant women were recruited from a nationwide

campaign and were followed prospectively in the last trimester and at 1 and

6 months postpartum. Standardized assessment of joint symptoms, examination

of inflamed joints, and the Health Assessment Questionnaire (HAQ) were the

main measures of disease activity.

Results

There was only a modest fall in HAQ scores during pregnancy, with >25%

of women having substantial levels of disability. Other parameters of

disease activity showed a greater trend toward improvement, although only 23

(16%) were in complete remission (no joints with active disease and no

therapy). Similarly, there was relatively little change in the distribution

of HAQ scores from pregnancy to postpartum. There was, however, a

statistically significant increase in the mean number of inflamed joints

compared with the findings during pregnancy. Analysis of the possible

influence of treatment suggested that therapy was associated with more

severe disease and was not related to reduction in disease activity.

Conclusion

This, the largest prospective study of the influence of pregnancy on

RA activity, has demonstrated widespread variability in disease response.

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Received: 12 August 1998; Accepted: 7 January 1999

http://www3.interscience.wiley.com/cgi-bin/abstract/79503251/ABSTRACT?CRETRY=1 & S\

RETRY=0

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