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: 
Consolidation registry (Ministry of Health)
PharmaNet
Stillbirths (BC Vital Statistics Agency)
consolidation - census geocodes
Perinatal Services BC
Deaths (BC Vital Statistics Agency)
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Births (BC Vital Statistics Agency)
Hospital Separations (BC 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

  • Manuscript (published) Tsao NW, Lynd LD, Sayre EC, Sadatsafavi M, Hanley G, De Vera MA. Use of biologics during pregnancy and risk of serious infections in the mother and baby: A Canadian population-based cohort study. BMJ Open. Feb 2019;9:e023714. doi: 10.1136/bmjopen-2018-023714.
  • 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: January 21, 2020