Document Detail

Measuring disease activity and functionality during pregnancy in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  17530669     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Pregnancy has a favorable effect on the course of rheumatoid arthritis (RA), although the magnitude of this effect is equivocal because RA assessment tools have never been validated in pregnancy. The goal of this study was to assess how pregnancy influences the scoring of the Disease Activity Score in 28 joints (DAS28) and the Health Assessment Questionnaire (HAQ), and how both scores perform in pregnant patients with RA. METHODS: Thirty-two healthy women and 30 pregnant patients with RA were prospectively studied during pregnancy and at postpartum. At each trimester and postpartum the components of the DAS28 (global health [GH], erythrocyte sedimentation rate [ESR], and C-reactive protein level [CRP]) and HAQ scores were determined. Maximal influences of healthy pregnancy on each component of the DAS28 were calculated. The performances of different DAS28 scores and the HAQ were also determined in RA patients. Furthermore, variants of the HAQ were developed within the HAQ scoring rules. RESULTS: The components of the DAS28 were influenced by healthy pregnancy, with average increases in DAS28 score of 0.22 (GH), 1.1 (ESR), and 0.25 (CRP). The DAS28 calculated with CRP (DAS28-CRP) and without GH performed the best in pregnant RA patients. In healthy pregnancy, the median HAQ increased to 0.50 in the third trimester and was reduced by the HAQ variants to 0.25. CONCLUSION: Pregnancy considerably influences the scoring of the DAS28 and HAQ. RA disease activity in pregnant patients should preferably be calculated with DAS28-CRP without GH. Even with HAQ variants, influences of pregnancy on the assessment of functionality cannot be precluded.
Yaël A de Man; Johanna M W Hazes; Fleur E van de Geijn; Catharina Krommenhoek; Radboud J E M Dolhain
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  57     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-14     Completed Date:  2007-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  716-22     Citation Subset:  AIM; IM    
Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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MeSH Terms
Arthritis, Rheumatoid / blood,  diagnosis,  physiopathology*
Blood Sedimentation
C-Reactive Protein / analysis
Disability Evaluation*
Disease Progression
Health Status*
Pregnancy Complications*
Prospective Studies
Severity of Illness Index*
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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