Pregnancy Outcomes of Women Veterans with Autoimmune Disease

doi:10.1089/whr.2024.0078

. 2024 Sep 6;5(1):650-657.

doi: 10.1089/whr.2024.0078. eCollection 2024.

Pregnancy Outcomes of Women Veterans with Autoimmune Disease

Catherine A Sims^{1

2}, Dahima Cintron³, Kate Wallace⁴, Aimee Kroll-Desrosiers^{4

5}, Ankoor Shah^{1

2}, Jennifer M Gierisch^{1

6

7}, Karen M Goldstein^{1

6}, Kristin Mattocks^{4

5}

Affiliations

¹ Department of Medicine, Durham Veterans Affairs Healthcare System, Durham, North Carolina, USA.
² Division of Rheumatology, Department of Medicine, Duke University, Durham, North Carolina, USA.
³ Department of Medicine and Pediatrics, Division of Rheumatology, Duke University, Durham, North Carolina, USA.
⁴ VA Central Western Massachusetts VA Healthcare System, Leeds, Massachusetts, USA.
⁵ Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
⁶ Division of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
⁷ Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

PMID: 39391789
PMCID: PMC11462423
DOI: 10.1089/whr.2024.0078

Pregnancy Outcomes of Women Veterans with Autoimmune Disease

Catherine A Sims et al. Womens Health Rep (New Rochelle). 2024.

. 2024 Sep 6;5(1):650-657.

doi: 10.1089/whr.2024.0078. eCollection 2024.

Authors

Catherine A Sims^{1

2}, Dahima Cintron³, Kate Wallace⁴, Aimee Kroll-Desrosiers^{4

5}, Ankoor Shah^{1

2}, Jennifer M Gierisch^{1

6

7}, Karen M Goldstein^{1

6}, Kristin Mattocks^{4

5}

Affiliations

¹ Department of Medicine, Durham Veterans Affairs Healthcare System, Durham, North Carolina, USA.
² Division of Rheumatology, Department of Medicine, Duke University, Durham, North Carolina, USA.
³ Department of Medicine and Pediatrics, Division of Rheumatology, Duke University, Durham, North Carolina, USA.
⁴ VA Central Western Massachusetts VA Healthcare System, Leeds, Massachusetts, USA.
⁵ Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
⁶ Division of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
⁷ Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

PMID: 39391789
PMCID: PMC11462423
DOI: 10.1089/whr.2024.0078

Abstract

Background/objective: Women Veterans (WV) are exposed to unique risk factors for the development of autoimmune diseases (AID), which can increase risk of pregnancy complications. To characterize pregnancy outcomes in this population, our team performed a descriptive case series.

Methods: To identify WV with AID from the Center for Maternal and Infant Outcomes Research in Translation dataset, medical records were screened using diagnostic codes and medications. A protocolized chart review and extraction was performed.

Results: Twenty-five WV with AID were identified. The most frequently reported AID were inflammatory bowel disease (n = 4), psoriasis (n = 4), and undifferentiated connective tissue disease (n = 4). Forty-four percent of WV with AID experienced pregnancy complications, 32% utilized VA subspecialty care for AID management, and 40% did not seek health care at the VA during their pregnancy.

Conclusions: Identified pregnancies had a high frequency of complications with more than one in three Veterans lost to VA follow-up during pregnancy.

Keywords: Veterans; autoimmune disease; pregnancy; reproductive health.

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References

1. Tani C, Zucchi D, Haase I, et al. . Are remission and low disease activity state ideal targets for pregnancy planning in systemic lupus erythematosus? A multicentre study. Rheumatology (Oxford) 2021;60(12):5610–5619; doi: 10.1093/rheumatology/keab155 - DOI - PubMed
1. Ten Klooster PM, Oude Voshaar MAH, Fakhouri W, et al. . Long-term clinical, functional, and cost outcomes for early rheumatoid arthritis patients who did or did not achieve early remission in a real-world treat-to-target strategy. Clin Rheumatol 2019;38(10):2727–2736; doi: 10.1007/s10067-019-04600-7 - DOI - PubMed
1. Sims C, Golenbiewski J, Eudy AM, et al. . Hospital admissions and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. J Clin Rheumatol 2023;29(6):e124–e129; doi: 10.1097/RHU.0000000000001917 - DOI - PubMed
1. Shi Y, Li M, Liu L, et al. . Relationship between disease activity, organ damage and health-related quality of life in patients with systemic lupus erythematosus: A systemic review and meta-analysis. Autoimmun Rev 2021;20(1):102691; doi: 10.1016/j.autrev.2020.102691 - DOI - PubMed
1. Sarzi-Puttini P, Zen M, Arru F, et al. . Residual pain in rheumatoid arthritis: Is it a real problem? Autoimmun Rev 2023;22(11):103423; doi: 10.1016/j.autrev.2023.103423 - DOI - PubMed

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[1] Tani C, Zucchi D, Haase I, et al. . Are remission and low disease activity state ideal targets for pregnancy planning in systemic lupus erythematosus? A multicentre study. Rheumatology (Oxford) 2021;60(12):5610–5619; doi: 10.1093/rheumatology/keab155 - DOI - PubMed

[2] Tani C, Zucchi D, Haase I, et al. . Are remission and low disease activity state ideal targets for pregnancy planning in systemic lupus erythematosus? A multicentre study. Rheumatology (Oxford) 2021;60(12):5610–5619; doi: 10.1093/rheumatology/keab155 - DOI - PubMed

[3] Ten Klooster PM, Oude Voshaar MAH, Fakhouri W, et al. . Long-term clinical, functional, and cost outcomes for early rheumatoid arthritis patients who did or did not achieve early remission in a real-world treat-to-target strategy. Clin Rheumatol 2019;38(10):2727–2736; doi: 10.1007/s10067-019-04600-7 - DOI - PubMed

[4] Ten Klooster PM, Oude Voshaar MAH, Fakhouri W, et al. . Long-term clinical, functional, and cost outcomes for early rheumatoid arthritis patients who did or did not achieve early remission in a real-world treat-to-target strategy. Clin Rheumatol 2019;38(10):2727–2736; doi: 10.1007/s10067-019-04600-7 - DOI - PubMed

[5] Sims C, Golenbiewski J, Eudy AM, et al. . Hospital admissions and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. J Clin Rheumatol 2023;29(6):e124–e129; doi: 10.1097/RHU.0000000000001917 - DOI - PubMed

[6] Sims C, Golenbiewski J, Eudy AM, et al. . Hospital admissions and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. J Clin Rheumatol 2023;29(6):e124–e129; doi: 10.1097/RHU.0000000000001917 - DOI - PubMed

[7] Shi Y, Li M, Liu L, et al. . Relationship between disease activity, organ damage and health-related quality of life in patients with systemic lupus erythematosus: A systemic review and meta-analysis. Autoimmun Rev 2021;20(1):102691; doi: 10.1016/j.autrev.2020.102691 - DOI - PubMed

[8] Shi Y, Li M, Liu L, et al. . Relationship between disease activity, organ damage and health-related quality of life in patients with systemic lupus erythematosus: A systemic review and meta-analysis. Autoimmun Rev 2021;20(1):102691; doi: 10.1016/j.autrev.2020.102691 - DOI - PubMed

[9] Sarzi-Puttini P, Zen M, Arru F, et al. . Residual pain in rheumatoid arthritis: Is it a real problem? Autoimmun Rev 2023;22(11):103423; doi: 10.1016/j.autrev.2023.103423 - DOI - PubMed

[10] Sarzi-Puttini P, Zen M, Arru F, et al. . Residual pain in rheumatoid arthritis: Is it a real problem? Autoimmun Rev 2023;22(11):103423; doi: 10.1016/j.autrev.2023.103423 - DOI - PubMed

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Pregnancy Outcomes of Women Veterans with Autoimmune Disease

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Pregnancy Outcomes of Women Veterans with Autoimmune Disease

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