A population-based study of caesarean section in women with juvenile idiopathic arthritis

Carina Götestam Skorpen; Stian Lydersen; Kjell Å Salvesen; Marianne Wallenius

doi:10.1093/rap/rkad062

A population-based study of caesarean section in women with juvenile idiopathic arthritis

Rheumatol Adv Pract. 2023 Jul 28;7(2):rkad062. doi: 10.1093/rap/rkad062. eCollection 2023.

Authors

Carina Götestam Skorpen^{1

2}, Stian Lydersen³, Kjell Å Salvesen^{4

5}, Marianne Wallenius^{1

6}

Affiliations

¹ Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
² Department of Rheumatology Ålesund, Helse More og Romsdal HF, Ålesund, Norway.
³ Department of Mental Health, Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.
⁴ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Department of Obstetrics and Gynecology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
⁶ Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.

Abstract

Objectives: The literature on delivery methods in women with JIA is limited. Active inflammation is a risk factor for caesarean section (CS) in other arthritic diseases. A CS entails a higher risk for complications than vaginal delivery and restricted physical activity in the first weeks after birth. Our objective was to explore a possible association of inflammatory active disease and the proportion of CS in women with JIA.

Methods: Data from the Norwegian nationwide observational register RevNatus were linked with data from the Medical Birth Registry of Norway (MBRN). Cases comprised singleton births in women with JIA (n = 196) included in RevNatus from 2010 to 2019. Singleton births registered in the MBRN during the same period of time, excluding births in mothers with rheumatic inflammatory diseases, served as population controls (n = 575 798).

Results: CS was more frequent in women with JIA (20.4%) and in the subgroup of women with inflammatory active JIA (30.0%) than in population controls (15.6%). Women with active JIA had a risk for elective CS similar to population controls [risk difference 2.3% (95% CI -2.5, 12.9)] and a higher risk for emergency CS [risk difference 14.0% (95% CI 4.3, 27.4)] compared with population controls.

Conclusion: Women with active JIA had a higher risk for emergency CS, but not elective CS, compared with population controls.

Keywords: JIA; epidemiology; inflammation; pregnancy and rheumatic disease.