Medication use, age up caesarean delivery risk in women with AS

Maternal age and disease-related factors contribute to the increased rate of caesarean delivery in women with ankylosing spondylitis (AS), suggests a recent study.

The authors identified female patients with AS aged 20–49 years using the Korean Health Insurance Review and Assessment Service claims database. A total of 1,293 deliveries after AS diagnosis were included. Logistic regression analysis was conducted to determine factors related to caesarean births.

Of the total deliveries in women with AS, 657 were caesarean and 636 were vaginal births. Women who had caesarean vs vaginal deliveries were older, had a longer disease duration, and had a higher portion of primipara and dispensation of drugs.

The following factors contributed to a higher risk of caesarean delivery: maternal age (odds ratio [OR], 1.08, 95 percent confidence interval [CI], 1.04–1.12), disease duration (OR, 1.09, 95 percent CI, 1.03–1.14) and pre-eclampsia (OR, 3.94, 95 percent CI, 1.17–13.32).

Increased risks of caesarean delivery were also observed with the use of the following drugs as compared to no drug dispensation: nonsteroidal anti-inflammatory drugs (NSAID; OR, 1.64, 95 percent CI, 1.31–2.37), tumour necrosis factor inhibitor (TNFi), disease-modifying antirheumatic drugs (DMARD) or corticosteroids (OR, 2.01, 95 percent CI, 1.57–2.58).

Subgroup analysis in primiparas supported the above findings, revealing the association of maternal age or dispensation of NSAID alone or TNFi, DMARD or corticosteroids with a higher risk of caesarean delivery.

“Women with AS have reported a higher rate of caesarean births than healthy controls,” the authors noted.