Maternal-fetal outcomes in patients with immune mediated inflammatory diseases, with consideration of comorbidities: a retrospective cohort study in a large U.S. healthcare system Article Swipe
Yeon Mi Hwang
,
Qi Wei
,
Samantha N. Piekos
,
Bhargav Vemuri
,
Sevda Molani
,
Philip J. Mease
,
Leroy Hood
,
Jennifer Hadlock
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1101/2023.08.07.23293726
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1101/2023.08.07.23293726
Background Immune-mediated inflammatory diseases (IMIDs) are likely to complicate maternal health. However, literature data on patients with IMIDs undergoing pregnancy is scarce and often overlooks the impact of comorbidities. Methods We investigated 12 selected IMIDs: psoriasis, inflammatory bowel disease, rheumatoid arthritis, spondyloarthritis, multiple sclerosis, systemic lupus erythematosus, psoriatic arthritis, antiphospholipid syndrome, Sjögren’s syndrome, vasculitis, sarcoidosis, systemic sclerosis. We characterized patients with IMIDs prior to pregnancy (IMIDs group) based on pregnancy/maternal characteristics, comorbidities, and pre-pregnancy/prenatal immunomodulatory medications (IMMs) prescription patterns. We 1:1 propensity score matched the IMIDs cohort with people who had no IMID diagnoses prior to pregnancy (non-IMIDs cohort). Outcome measures were preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), and cesarean section. Findings The prevalence rate of pregnancy occurring with people with a previous IMID diagnosis has doubled in the past ten years. We identified 5,784 patients with IMIDs. 17% of the IMIDs group had at least one prenatal IMM prescription. Depending on the type of IMM, from 48% to 70% of the patients taking IMMs before pregnancy continued them throughout pregnancy. Patients with IMIDs had similar but slightly increased risks of PTB (Relative risk (RR)=1·1[1·0, 1·3]), LBW (RR=1·2 [1·0,1·4]), SGA (RR=1·1 [1·0,1·2]), and cesarean section (RR=1·1 [1·1,1·2]) compared to a matched cohort of people without IMIDs. Out of the 12 selected IMIDs, three for PTB, one for LBW, two for SGA, and six for cesarean section had results supporting increased risk. Interpretation The association between IMIDs and the increased risk of adverse pregnancy outcomes depend on both the nature of the IMID and the presence of comorbidities. Funding NIH
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2023.08.07.23293726
- https://www.medrxiv.org/content/medrxiv/early/2023/08/09/2023.08.07.23293726.full.pdf
- OA Status
- green
- Cited By
- 1
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4385755277
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4385755277Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2023.08.07.23293726Digital Object Identifier
- Title
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Maternal-fetal outcomes in patients with immune mediated inflammatory diseases, with consideration of comorbidities: a retrospective cohort study in a large U.S. healthcare systemWork title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-08-09Full publication date if available
- Authors
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Yeon Mi Hwang, Qi Wei, Samantha N. Piekos, Bhargav Vemuri, Sevda Molani, Philip J. Mease, Leroy Hood, Jennifer HadlockList of authors in order
- Landing page
-
https://doi.org/10.1101/2023.08.07.23293726Publisher landing page
- PDF URL
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https://www.medrxiv.org/content/medrxiv/early/2023/08/09/2023.08.07.23293726.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.medrxiv.org/content/medrxiv/early/2023/08/09/2023.08.07.23293726.full.pdfDirect OA link when available
- Concepts
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Retrospective cohort study, Medicine, Cohort, Healthcare system, Immune system, Health care, Fetus, Pregnancy, Intensive care medicine, Obstetrics, Immunology, Internal medicine, Economic growth, Biology, Economics, GeneticsTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2024: 1Per-year citation counts (last 5 years)
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26Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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