Clinical Aspects of Pregnancy-induced Amelioration of Rheumatoid Arthritis: PARA-study
(Klinische aspecten van door zwangerschap geïnduceerde verbetering van reumatoïde artritis: PARA-studie)
In this PhD thesis, embedded in the PARA (Pregnancy-induced Amelioration of Rheumatoid Arthritis) study, several clinical aspects of the spontaneously occurring pregnancy-induced improvement of rheumatoid arthritis (RA) are addressed. An overview is given of inflammatory rheumatic diseases and the current knowledge about their disease courses and treatment options during pregnancy and postpartum. This thesis focuses firstly on the description of tools to objectively measure the disease activity and functionality of RA before, during and after pregnancy. Associations with the disease course and patient’s characteristics are subsequently made. The influence on the pregnancy outcome of both disease activity and treatment of RA with prednisone, are assessed regarding pregnancy durations and birth weight. Postpartum however RA tends to flare again. The problems which patients with RA will encounter in parental function, while nursing their babies, are addressed.
Financial support for the publication of this thesis was kindly provided by the Dutch Arthritis
Association (Reumafonds), ABBOTT B.V., Roche Nederland B.V., Schering-Plough B.V.,
Wyeth Pharmaceuticals, and the Department of Rheumatology, Erasmus MC, University
Medical Center Rotterdam.
- rheumatoid arthritis
- pregnancy outcome
- pharmacological treatment
- parenting disability index
- disease activity score