ArticleArthritis care & research2020
Mediation of Adverse Pregnancy Outcomes in Autoimmune Conditions by Pregnancy Complications: A Mediation Analysis of Autoimmune Conditions and Adverse Pregnancy Outcomes.
Article in Arthritis care & research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Impact of maternal psoriasis on adverse maternal and neonatal outcomes: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2023Pooled it
- Mendelian randomization study reveals a causal relationship between rheumatoid arthritis and risk for pre-eclampsia.Frontiers in immunology · 2022Pooled it
- Pooled it
- Maternal autoimmune diseases during pregnancy and mortality up to young adulthood in offspring: a register-based cohort study.EClinicalMedicine · 2026Article
- Article
- Pharmacokinetics of Certolizumab Pegol in Pregnancy: Results from the Open-Label CHERISH Study.Rheumatology and therapy · 2026Article
- Management of Pregnancy in Women with Inflammatory Bowel Disease: Positioning Janus Kinase Inhibitors Within Current Evidence.Current issues in molecular biology · 2026Review
- Associations of prenatal exposure to maternal autoimmune disorders with a wide spectrum of psychiatric and neurodevelopmental disorders in offspring-a nationwide cohort study.Human reproduction open · 2026Article
- A Cohort Study of Pregnancy and Fetal Complications Among Patients with Rheumatologic Disorders.Journal of obstetrics and gynaecology of India · 2025Article
- Cardiovascular Events During Pregnancy: Implications for Adverse Pregnancy Outcomes in Individuals With Autoimmune and Rheumatic Diseases.The Journal of rheumatology · 2025Article
- Patterns of reproductive health in inflammatory rheumatic diseases and other immune-mediated diseases: a nationwide registry study.Rheumatology (Oxford, England) · 2024Article
- Pregnancy complications and new-onset maternal autoimmune disease.International journal of epidemiology · 2024Article
- The possible impact of the universal two-child policy on pregnancy outcomes.Archives of gynecology and obstetrics · 2024Article
- Pregnancy Recommendations Solely Based on Preclinical Evidence Should Be Integrated with Real-World Evidence: A Disproportionality Analysis of Certolizumab and Other TNF-Alpha Inhibitors Used in Pregnant Patients with Psoriasis.Pharmaceuticals (Basel, Switzerland) · 2024Article
- [Clinical characteristics of pregnancy complicated with inflammatory bowel disease].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2024Article
- Prenatal Exposure to Opioids and Neurodevelopmental Disorders in Children: A Bayesian Mediation Analysis.American journal of epidemiology · 2024Article
- Management of Rheumatic Diseases During Pregnancy and Breastfeeding: Position Paper of the Working Group for Obstetrics and Prenatal Medicine in the German Society for Gynecology and Obstetrics e. V. (AGG - Section Maternal Diseases in Pregnancy).Geburtshilfe und Frauenheilkunde · 2024Article
- Article
- Prenatal acetaminophen use in women with autoimmune disorders and adverse pregnancy and birth outcomes.Rheumatology (Oxford, England) · 2022Article
- Impact of Psoriasis and Hidradenitis Suppurativa in Pregnancy, a Systematic Review.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveAutoimmune conditions are associated with an increased risk of adverse pregnancy complications and outcomes, suggesting that pregnancy complications may mediate the excess risk. We performed a causal mediation analysis to quantify the mediated effects of autoimmune conditions on adverse pregnancy outcomes.
methodsWe queried a California birth cohort created from linked birth certificates and hospital discharge summaries. From 2,963,888 births, we identified women with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), psoriasis, and inflammatory bowel disease (IBD). Pregnancy complications included preeclampsia/hypertension, gestational diabetes mellitus, and infection in pregnancy. Adverse pregnancy outcomes were preterm birth, cesarean delivery, and small for gestational age. We performed a mediation analysis to estimate the total effects of each autoimmune condition and adverse pregnancy outcome and the indirect effects through pregnancy complications.
resultsAll 4 autoimmune conditions were associated with preterm birth and cesarean delivery, and RA, SLE, and IBD were associated with offspring that were small for gestational age. The strongest mediator of RA, SLE, and psoriasis was preeclampsia/hypertension, accounting for 20-33% of the excess risk of preterm births and 10-19% of excess cesarean deliveries. Gestational diabetes mellitus and infections generally mediated <10% of excess adverse pregnancy outcomes. Of the 4 autoimmune conditions, selected pregnancy complications mediated the least number of adverse pregnancy outcomes among women with IBD.
conclusionWe found evidence that some excess risk of adverse pregnancy outcomes is mediated through pregnancy complications, particularly preeclampsia/hypertension. Quantifying excess risk and associated pathways provides insight into the underlying etiologies of adverse pregnancy outcomes and can inform intervention strategies.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.