The Impact of Arthritis Medications During Pregnancy on Maternal and Neonatal Health Outcomes

Project number: 
13-084
Approval date: 
Tuesday, March 18, 2014
Principal Investigator: 
De Vera,Mary
Institution: 
University of British Columbia (UBC)
Funding Agency: 
The Arthritis Society,Canadian Institutes of Health Research(CIHR)
Datasets requested: 
Hospital Separations (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Deaths (BC Vital Statistics Agency)
Medical Services Plan (BC Ministry of Health)
Perinatal Services BC
Births (BC Vital Statistics Agency)
PharmaNet
Stillbirths (BC Vital Statistics Agency)
consolidation - census geocodes
Consolidation registry (Ministry of Health)
Research objective: 

Objective 1: Describe perinatal use of arthritis medications by: a) quantifying prevalence of use of arthritis medications; and b) describing patterns of use in the year before, during, and the year after pregnancy. As this is a descriptive objective, we will not formally test hypotheses.

Research Question 1: What is the prevalence and pattern of arthritis medication use before, during, and after pregnancy among women with arthritis.

Objective 2: Assess maternal outcomes associated with perinatal use of arthritis medications by quantifying the magnitude of the risk of: a) spontaneous abortions and b) caesarean deliveries to test hypothesis that arthritis medications impact health outcomes of the mother.

Research Question(s) 2: Do arthritis medications increase the risk of spontaneous abortions? Do arthritis medications increase the risk of caesarean deliveires?

Objective 3: Assess neonatal outcomes associated with perinatal use of arthritis medications by quantifying the magnitude of the risk of: a) major congenital malformations and b) small for gestational age to test hypothesis that arthritis medications impact health outcomes of the child.

Research Question(s) 3: Do arthritis medications increase the risk of having infants with major congenital malformations? Do arthritis medications increase the risk having infants who are small-for-gestational-age?

Publications: 

Journal Publication

  • Tsao NW, Sayre EC, Hanley G, Sadatsafavi M, Lynd LD, Marra CA, De Vera MA. Risk of Preterm Delivery and Small-for-Gestational-Age Births in Women with Autoimmune Disease Using Biologics Before or During Pregnancy: A Population-Based Cohort Study. Annals of the Rheumatic Diseases. 2018 Mar 1. doi: 10.1136/annrheumdis-2018-213023. [Epub ahead of print]. PMID: 29496718.
  • Tsao NW, Lynd LD., Sadatsafavi M, Hanley G, De Vera MA. Patterns of Biologics Utilization and Discontinuation Before and During Pregnancy in Women with Autoimmune Diseases: A Population-Based Cohort Study. Arthritis Care Research (Hoboken). 2017 Oct 3; doi: 10.1002/acr.23434. [Epub ahead of print]. PMID 28973840.

Presentation of research material (poster/seminar/lecture etc.)

  • Tsao NW, Lynd LD, Marra CA, Sayer E, De Vera MA. Patterns of Biologics Use among Women with Autoimmune Disease Before, During, and After Pregnancy: A Population-based Study. Poster presentation. Canadian Rheumatology Association Conference. February 2016
  • Tsao NW. Patterns of Biologics Use among Women with Autoimmune Disease Before, During, and After Pregnancy: A Population-based Study. Oral presentation. Arthritis Research Canada - University of California San Francisco Joint Research Day. February 2016
  • De Vera MA, Sayre EC, Tsao NW, Avina-Zubieta JA. Perinatal patterns of medication use in women with rheumatoid arthritis: A population-based study. Poster presentation. American College of Rheumatology Annual Meeting. September 2015

Conference abstract/presentation

  • Tsao NW, Sayre EC, Sadatsafavi M, Avina-Zubieta JA, Ensworth S, De Vera MA. Risk of Preterm Delivery Associated with Perinatal Exposure to DMARDs in Women with Inflammatory Arthritis: A Population-based Cohort Study. American College of
    Rheumatology (ACR) Conference 2017. San Diego, CA, USA. November 4 – 7, 2017.
  • Tsao NW, Sayre EC, Howren A, De Vera MA. Perinatal exposure to disease modifying antirheumatic drugs in women with inflammatory arthritis and the risk of small-for-gestational-age newborns: A population-based cohort study. European League Against Rheumatism (EULAR) Annual European Congress of Rheumatology 2018. Amsterdam, Netherlands. June 13-16, 2018.
  • De Vera MA, Sayre EC, Tsao NW, Howren A. Risk of major congenital malformations associated with exposure to conventional synthetic disease modifying antirheumatic drugs in women with inflammatory arthritis: A population-based cohort study. European League Against Rheumatism (EULAR) Annual European Congress of Rheumatology 2018. Amsterdam, Netherlands. June 13-16, 2018.
  • Tsao NW, Hanley G, Sadatsafavi M, Lynd LD, Marra C, De Vera MA. Risk of Major Congenital Malformations Associated with Exposure to Biologics Before or During Pregnancy: A Population-based Cohort Study. 2018 Canadian Rheumatology Association Annual Scientific Meeting, Vancouver, Canada. February 21 – 24, 2018.
  • Conference Presentation
    Tsao N, Lynd L, Sadatsafavi M, Li K, Sayre E, De Vera MA. Discontinuation of Biologic Drugs 1-year Before Pregnancy and During Pregnancy: A Real-World Comparison between Inflammatory Bowel Disease and Rheumatoid Arthritis. Canadian Rheumatology Association Annual Scientific Meeting, Ottawa, Ontario, February 8-11, 2017

Page last revised: May 13, 2019