Increased Adverse Pregnancy Outcomes in Ankylosing Spondylitis Save

Although ankylosing spondylitis affects a predominantly male population, the ratio of men to women has declined from 9-10:1 in earlier studies to more recent estimates of 2-3:1 (F:M).

A nation-wide population based case-control study was conducted in Sweden, aimed at evaluating pregnancy outcomes in women with ankylosing spondylitis (AS). 

From 388 patients enrolled, 16.5% underwent emergency C-section comparing at only 6.5% among healthy controls. It was also observed that newborns of women with AS were more often preterm (9% vs 4.9%) or small for gestational age (SGA) (3.1% vs 1.5%).

Adjustment for most common co-founders did not change results significantly. Interestingly enough, extensive use of DMARDs was associated with higher risk of newborns being of SGA. Elective C-sections were observed more often in patient on DMARDs.

The study concluded that both the disease severity and co-morbidities contribute to a higher risk of particular birth outcomes in women with ankylosing spondylitis.