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- Title
Reasons for the High Cesarean Delivery Rate among Women with Ankylosing Spondylitis: Using the Korean National Health Insurance Database.
- Authors
Jung Sun Lee; Ji Seon Oh; Ye-Jee Kim; Seokchan Hong; Chang-Keun Lee; Bin Yoo; Yong-Gil Kim; Lee, Jung Sun; Oh, Ji Seon; Kim, Ye-Jee; Hong, Seokchan; Lee, Chang-Keun; Yoo, Bin; Kim, Yong-Gil
- Abstract
<bold>Objective: </bold>Women with ankylosing spondylitis (AS) have reported a higher rate of cesarean births than healthy controls. This study aimed to identify factors associated with cesarean births in women with AS.<bold>Methods: </bold>Based on the Korean Health Insurance Review and Assessment Service claims database, the subjects comprised female patients aged 20-49 years old with AS. In total, 1293 deliveries after AS diagnosis were included. A logistic regression analysis was performed to identify factors associated with cesarean births.<bold>Results: </bold>Among the 1293 deliveries in women with AS, 657 were cesarean and 636 were vaginal deliveries. Compared to vaginal delivery, the women who had cesarean deliveries were older, had a longer disease duration, and had a higher portion of primipara and dispensation of drugs. These factors were associated with a higher risk of cesarean delivery: maternal age (OR 1.08, 95% CI 1.04-1.12), disease duration (OR 1.09, 95% CI 1.03-1.14), and preeclampsia (OR 3.94, 95% CI 1.17-13.32). Further, compared to no drug dispensation, these drugs showed higher risks of cesarean delivery: nonsteroidal antiinflammatory drugs (NSAID; OR 1.64, 95% CI 1.31-2.37), tumor necrosis factor inhibitor (TNFi), disease-modifying antirheumatic drugs (DMARD), or corticosteroids (OR 2.01, 95% CI 1.57-2.58). In the subgroup analysis in primiparas, maternal age, or dispensation of NSAID alone, or TNFi, DMARD, or corticosteroids was associated with a higher risk of cesarean delivery.<bold>Conclusion: </bold>Women with AS showed a higher cesarean delivery rate, influenced by both maternal age and disease-related factors.
- Publication
Journal of Rheumatology, 2020, Vol 47, Issue 5, p668
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.190754