Pregnancy outcomes in adult patients with dermatomyositis and polymyositis
Kathleen D. Kolstad M.D., Ph.D 1, David Fiorentino M.D., Ph.D 2, Shufeng Li M.S. 2,3, Eliza F. Chakravarty M.D., M.S. 4, Lorinda Chung M.D., M.S.1*
1. Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
2. Department of Dermatology, Stanford University School of Medicine, Redwood City, CA
3. Department of Urology, Stanford University School of Medicine, Palo Alto, CA
4. Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK
* Corresponding author. VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304. E-mail address: shauwei@stanford.edu. …show more content…
We assessed pregnancy outcomes in DM and PM patients compared with the general obstetric population.
Methods:
The Nationwide Inpatient Sample (NIS) (1993-2007) was used to identify adult obstetric women with DM or PM (DM/PM n = 1289). Controls were from the general obstetric population hospitalized in 2007. Pregnancy outcomes included length of hospital stay (LOS), hypertensive disorders (HTN), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), and cesarean delivery. Multivariate regression analyses were performed using maternal age, race/ethnicity, and diabetes mellitus as covariates. …show more content…
International Classification of Diseases-Clinical Modification-9 Codes for the Diagnosis of Dermatomyositis and Polymyositis in Discharge Summaries: Evidence of Acceptable Validity. [abstract]. Arthritis Rheum 2011;63 Suppl 10:244). An additional limitation is that we did not assess influence of concomitant autoimmune disorders in our population that may influence obstetric outcomes. For example, scleroderma and SLE can overlap with myositis, both of which have the potential to worsen obstetric outcomes (25-27). However, we wanted to avoid misclassification and therefore excluded patients with ICD-9 codes for other CTDs in addition to DM or PM. Due to the limitations of our dataset, we were also unable to assess disease activity during pregnancy, treatments received, autoantibody status, or time of diagnosis in relation to pregnancy outcomes. In addition, because our data are de-identified, we were unable to link neonatal outcomes to maternal data. Spontaneous abortions also could not be assessed as the obstetric cases in our study were only identified after 20 weeks gestation and the majority of such losses occur earlier in
Kathleen D. Kolstad M.D., Ph.D 1, David Fiorentino M.D., Ph.D 2, Shufeng Li M.S. 2,3, Eliza F. Chakravarty M.D., M.S. 4, Lorinda Chung M.D., M.S.1*
1. Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
2. Department of Dermatology, Stanford University School of Medicine, Redwood City, CA
3. Department of Urology, Stanford University School of Medicine, Palo Alto, CA
4. Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK
* Corresponding author. VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304. E-mail address: shauwei@stanford.edu. …show more content…
We assessed pregnancy outcomes in DM and PM patients compared with the general obstetric population.
Methods:
The Nationwide Inpatient Sample (NIS) (1993-2007) was used to identify adult obstetric women with DM or PM (DM/PM n = 1289). Controls were from the general obstetric population hospitalized in 2007. Pregnancy outcomes included length of hospital stay (LOS), hypertensive disorders (HTN), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), and cesarean delivery. Multivariate regression analyses were performed using maternal age, race/ethnicity, and diabetes mellitus as covariates. …show more content…
International Classification of Diseases-Clinical Modification-9 Codes for the Diagnosis of Dermatomyositis and Polymyositis in Discharge Summaries: Evidence of Acceptable Validity. [abstract]. Arthritis Rheum 2011;63 Suppl 10:244). An additional limitation is that we did not assess influence of concomitant autoimmune disorders in our population that may influence obstetric outcomes. For example, scleroderma and SLE can overlap with myositis, both of which have the potential to worsen obstetric outcomes (25-27). However, we wanted to avoid misclassification and therefore excluded patients with ICD-9 codes for other CTDs in addition to DM or PM. Due to the limitations of our dataset, we were also unable to assess disease activity during pregnancy, treatments received, autoantibody status, or time of diagnosis in relation to pregnancy outcomes. In addition, because our data are de-identified, we were unable to link neonatal outcomes to maternal data. Spontaneous abortions also could not be assessed as the obstetric cases in our study were only identified after 20 weeks gestation and the majority of such losses occur earlier in