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Dr. Jack Cush reviews the news and journal reports and takes viewer questions this week.
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Drs. Jack Cush and Artie Kavanaugh review the highlights of the RWCS (Rheumatology Winter Clinical Symposium) from Maui.
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The Global Rheumatology Alliance (GRA) has studied the outcomes of women with rheumatic disease who were pregnant at the time of infection with coronavirus disease 2019 (COVID-19).
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It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen journal articles, news reports and questions + cases.
Dr. John Cush
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Adverse pregnancy outcomes and Risks in #SLE. (Dr. Eliza Chakravarty - OMRF) #UTSWSLE2022 https://t.co/HqscJD2m96
Dr. John Cush
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Nearly 40% of all #SLE pregnancies are unplanned - hence, contraception (unused in 73%) and education are paramount in management of women w/ SLE. (Dr. Lisa Sammaritano- HSS) #UTSWSLE2022 https://t.co/ooryrW9GGn
Dr. John Cush
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Danish case-control registry of 491,274 women shows Psoriasis assoc w/ increased risk of ectopic pregnancy (EP) (OR 1.34), highest in women w/ moderate-to-severe psoriasis (OR 2.77). EP risk was 2.5x higher for women w/ mod--severe PSO https://t.co/vUtNEMDOhr
Dr. John Cush
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Canadian study of 6012 Pregnancies w/ +COVID-19 PCR test shows Preg pts increased risk of hospitalization (RR 2.65) & ICU adm (RR 5.46) vs gen population and higher risk of preterm birth vs preg women without COVID (RR 1.63) https://t.co/6UAaa0Jf8j https://t.co/aLQbxZArmq
Dr. John Cush
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Pregnancy outcomes in systemic sclerosis (SSc) studied in 154 pregnancies from SSc, SLE, APS, & controls (2008 to 2019). Adverse Preg Outcomes APO significantly higher in SSc vs HC (61% vs 10%) w/ more miscarriages, preeclampsia, SGA & preterm births https://t.co/P3uksmJy6V https://t.co/nTtgwjdGgL
Dr. John Cush
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UK drug safety warning, observational data 2700 pregnancies, 1st trimester pregabalin (Lyrica) use was assoc w/ higher rate of congenital malformations (5.9 vs 4.1%). US PI label says Lyrica use in Pregnancy "May cause fetal harm". https://t.co/GdIitpe8KW
Edward Loftus
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Steroids associated with adverse events during pregnancy @UmaMahadevanIBD @MayoClinicGIHep https://t.co/VR5CZUH1S7
Dr. John Cush
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JAMA reports another study showing safety of COVID-19 vaccination during pregnancy with no incr in adverse pregnancy outcomes. Scand study of 157,521 births - 0.7%, 8.3%, 9.1% of were vaxD during 1st, 2nd, 3rd trimesters https://t.co/dZuabwr1Sf https://t.co/CtzMoEV1Ee
Dr. John Cush
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Canadian population study shows that mRNA COVID-19 vaccination DURING 2nd &3rd trimester of pregnancy did not increase rate of adverse peripartum outcomes (vs no vax or vax post-Preg). Comparison of 97 590 Preg vs 44 815 non-preg https://t.co/n7nWcoLw4S https://t.co/uiVOg5A1S8
Dr. John Cush
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ICYMI: Drugs for Pregnancy Hopefuls
A Young Woman has uncontrolled RA, but wants to get pregnant.
What do you chose?
https://t.co/Sunx8RWRfM https://t.co/hsFNhVfwHd
Dr. John Cush
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98 axial SpA women with 335 pregnancies (279 live births) shows preterm birth ( (12.5 v 5.2%), preeclampsia(6.8 v 2.8%) & LBW (8.2 v 2.9%) more prevalent in axSpA, possibly due to incr disease activity during pregnancy & postpartum https://t.co/Bp8QjBXg2K https://t.co/j0xKVvSPIH
Robert B Chao, MD
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Healthy mother = healthy baby
Pregnancy and neonatal complications linked to disease activity and inflammation
@RheumNow #RNL2022 https://t.co/MeBnYnSfuK
Dr. John Cush
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Retrospective cohort study of 338 pregnancies in IMID pts (~1/2 w/ IBD); 23% w/ biologic exposure had increase in post-partum flares (OR 3.44) & less being breastfeed (OR 0.44). Maternal and neonatal pregnancy outcomes were similar https://t.co/8pu2p8tK0s https://t.co/bVQx9La5j3
Dr. John Cush
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Postpartum maternal outcomes Study compared 202 RA pts to 596 non-RA controls. There was no difference in infection rates or transfusions, but RA was assoc w/ more preterm births (OR = 2.11). Steroids (41%) were associated with lower birthweight https://t.co/F8DKmEHh0M https://t.co/d4Jkb3huMy
Dr. John Cush
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MMWR study of shows 2 dose mRNA COVID vax during pregnancy was 61% effective preventing infant COVID. Among 176 infants hosp w/ COVID-19, 84% were born to mothers who were not vaccinated during pregnancy.https://t.co/mWgHHcL05u
Dr. John Cush
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ICYMI: MMWR reports >40,000 pregnant women who received COVID-19 vaccination during pregnancy- VAX not associated with preterm birth or small-for-gestational-age at birth overall compared with unvaccinated pregnant women. https://t.co/GtRMsNrFnn
