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Gold Therapy in Women Planning Pregnancy: Outcomes in One Center MOHAMMED ALMARZOUQI, DEBRA SCARSBROOK, and ALICE KLINKHOFF
ABSTRACT. Methods. We undertook a chart review of patients attending for gold injection and monitoring between January 1992 and April 2006. For women who became pregnant while being followed taking gold therapy, we extracted demographic, treatment, and disease activity data, information regarding pregnancy complications, outcome, and postpartum course. For details missing from the clinic records, patients were interviewed by the clinic nurse. Results. Fourteen women experienced 20 pregnancies while being followed in the gold monitoring clinic. Mean age at the time of conception was 34.5 years (range 24–41), disease duration 8.5 years (1–16). Rheumatoid factor was positive in 9 of 14 women. Duration taking gold prior to conception was < 12 months in 7 pregnancies, 13–24 months in 4, 25–34 months in 2, and 2–10 years in 7 pregnancies. Four women continued taking gold until delivery. The rest of the women discontinued gold when they knew they were pregnant, with the exception of one who held her gold 4 weeks prior to conception. There were 5 spontaneous abortions in the first trimester; included were 2 spontaneous abortions in a woman with known Robertsonian chromosomal translocation. Sixteen babies were healthy including a pair of twins. One baby was born with weakness of one extraocular muscle requiring surgery; one had blocked tear ducts at birth. Rheumatoid arthritis (RA) flared during 3/15 completed pregnancies and postpartum and post-spontaneous abortion in 18/20 pregnancies. Conclusion. Our clinic experience and the published literature support the current practice that in patients with RA, gold may still be considered a treatment option in women planning pregnancy. (First Release August 1 2007; J Rheumatol 2007;34:1827-31) Key Indexing Terms:
GOLD
From the University of British Columbia and the Mary Pack Arthritis Program, Vancouver, British Columbia, Canada. M. Almarzouqi, MD; D. Scarsbrook, BSN, Clinical Nurse Specialist, Mary Pack Arthritis Program; A. Klinkhoff, MD, Clinical Associate Professor, Division of Rheumatology, University of British Columbia. Address reprint requests to Dr. A. Klinkhoff, 895 West 10th Ave., Vancouver, BC V5Z 1L7, Canada. E-mail: alice.klinkhoff@vch.ca Accepted for publication May 5, 2007. |
