Impact of pregnancy on sacroiliac imaging in women with axial spondyloarthritis: results of the analysis of the DESIR cohort

Abstract

Objective

In postpartum healthy women, inflammatory lesions of the sacroiliac joint (SIJ) can appear and mimic sacroiliitis. However, the impact of delivery on imaging abnormalities in women with axial spondyloarthritis (axSpA) is unknown. Thus, this study aimed to evaluate the impact of delivery on SIJ imaging in early axSpA.

Method

Women with axSpA from the French prospective cohort DESIR were included, with a follow-up of 5 years. Demographic and disease characteristics, and SIJ imaging abnormalities at baseline, were described in all women and then according to nulliparous status. Changes on imaging over time were analysed in the 38 women who were nulliparous at baseline and had their first pregnancy with delivery during follow-up.

Results

At baseline, nulliparous women were younger and had a higher educational level than other women with axSpA. The presence of sacroiliitis on magnetic resonance imaging (MRI) and X-ray was more frequent in nulliparous women (16.9% vs 9.9% and 33.8% vs 19.4%, respectively). When focusing on first incident deliveries, these patients had more sacroiliitis on X-ray and MRI at baseline than nulliparous patients at the end of follow-up, but lower Ankylosing Spondylitis Disease Activity Score–C-reactive protein (ASDAS-CRP). Only the modified New York score on the left SIJ was statistically different after delivery.

Conclusion

Pregnancy with delivery does not seem to aggravate imaging in women with. Following axSpA patients who had their first delivery showed a mild increase in left sacroiliitis on X-ray after delivery, but without other signs of structural or inflammatory aggravation on imaging.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

EP and AM carried out the study conception, design, analysis, and interpretation of the data. EP drafted the article. All authors critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Additional information

Funding

Financial support was received from the Société Française de Rhumatologie.