A recent study published in Rheumatic and Musculoskeletal Diseases has shed light on the potential risks posed by certain medications used in the treatment of rheumatoid arthritis (RA) during pregnancy. The study, based on data from a national health insurance database, suggests that treatment with methotrexate and leflunomide may increase the risk of adverse pregnancy outcomes (APOs) in women with RA. These findings emphasize the importance of careful medication management and planning for pregnancy in this patient population.
RA disproportionately affects women, and the prevalence of the condition among women of childbearing age underscores the need for comprehensive care during pregnancy and childbirth. Previous research has indicated that RA patients may face challenges related to fertility and pregnancy, potentially influenced by factors such as disease activity and medication usage.
To better understand the factors contributing to APOs in pregnant women with RA, researchers analyzed data from the Korean National Health Insurance (NHI) database. The study focused on pregnant women aged 20 to 50 years with RA between 2010 and 2020, categorizing patients based on pregnancy outcomes. Medication utilization patterns, including various disease-modifying antirheumatic drugs (DMARDs) and other medications, were compared between groups, and factors associated with APOs were identified using statistical analysis.
The analysis included a total of 5729 pregnancies, with patients divided into delivery and APO groups based on pregnancy outcomes. Among the medications studied, methotrexate and leflunomide were found to be associated with a higher risk of APOs when used within three months prior to conception. Other factors linked to APOs included maternal age and the type of healthcare institution where patients received treatment.
While the study provides valuable insights into the potential risks of specific medications during pregnancy, the researchers note certain limitations, including the lack of data on disease activity and challenges in accurately determining conception dates from the database.
In light of these findings, the researchers emphasize the importance of thorough consultations with healthcare providers for RA patients planning for pregnancy. Close medical supervision throughout pregnancy is crucial for effectively managing disease activity and minimizing the risk of APOs. Moving forward, continued research efforts are needed to better understand the complex interactions between RA, medication usage, and pregnancy outcomes, ultimately improving care and outcomes for pregnant women with RA.
