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THU0618 Disease Activity during and after Pregnancy in Women with Juvenile Idiopathic Arthritis: Results from A Prospective Multicenter Study

Background Studies from the 1990s have demonstrated that the majority of women with juvenile idiopathic arthritis (JIA) experience decreased disease activity during pregnancy while about 50% flare post partum (1–3). However, these studies were retrospective studies without validated disease activity measures. DAS28 is a validated disease activity measure in women with JIA, and DAS28-CRP-3 is a validated disease activity measure during pregnancy in women with rheumatoid arthritis (4). Objectives The aim of this project was to prospectively study disease activity in women with JIA during pregnancy and until one year post partum with DAS28-CRP-3 as disease activity measure. Methods RevNatus is a Norwegian national research database, designed for the follow-up of women with inflammatory rheumatic diseases during and after pregnancy. The women have 6 or 7 visits at a rheumatology unit; before conception if possible (visit 0), in each trimester (visit 1–3), and 6 weeks, 6 months and 12 months post partum (visit 4–6). RevNatus included 135 fullterm pregnancies in 114 women with JIA between 2006 and 2015. To explore disease activity throughout pregnancy and until one year post partum, DAS28-CRP-3-values registrered at each visit were analyzed in a three level linear mixed model. Results Analyzing DAS28-CRP-3-values from 6 time points throughout and after pregnancy in 135 pregnancies in 114 women with JIA, we found that disease activity 6 weeks post partum was significantly higher than disease activity in first trimester (p=0,004), in third trimester (p=0,011) and 12 months post partum (p=0,015). Results are displayed in figure shown below. Conclusions In 135 pregnancies in women with JIA disease activity increased significantly from pregnancy to 6 weeks post partum, and then decreased significantly between 6 weeks and 12 months post partum. The results call for tight follow-up of women with JIA in the first weeks after delievery. References Ostensen M. The effect of pregnancy on ankylosing spondylitis, psoriatic arthritis, and juvenile rheumatoid arthritis. Am J Reprod Immunol. 1992;28(3–4):235–7. Epub 1992/10/01. Ostensen M. Pregnancy in patients with a history of juvenile rheumatoid arthritis. Arthritis Rheum. 1991;34(7):881–7. Epub 1991/07/01. Musiej-Nowakowska E, Ploski R. Pregnancy and early onset pauciarticular juvenile chronic arthritis. Ann Rheum Dis. 1999;58(8):475–80. Epub 1999/07/27. de Man YA, Hazes JM, van de Geijn FE, Krommenhoek C, Dolhain RJ. Measuring disease activity and functionality during pregnancy in patients with rheumatoid arthritis. Arthritis Rheum. 2007;57(5):716–22. Epub 2007/05/29. Disclosure of Interest None declared