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Four subgroups were formed based on SpA diagnosis and childbirth (CB) history. Two musculoskeletal radiologists scored the presence of BME and sclerosis on SIJ-MRI using the Berlin method. Further, an 11-point \u201cglobal assessment score\u201d representing the overall confidence of SpA diagnosis based on MRI was evaluated in addition to the ASAS (Assessment of Spondyloarthritis International Society) criterion of \u201cpositive MRI\u201d for sacroiliitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>CB did not correlate with BME score (<jats:italic>p<\/jats:italic> = 0.38), whereas SpA diagnosis was associated with a higher BME score (<jats:italic>r<\/jats:italic> = 0.31, <jats:italic>p<\/jats:italic> &lt; 0.001). Both CB (<jats:italic>r<\/jats:italic> = 0.21, <jats:italic>p<\/jats:italic> &lt; 0.001) and SpA diagnosis (<jats:italic>r<\/jats:italic> = 0.33, <jats:italic>p<\/jats:italic> &lt; 0.001) were correlated with a higher sclerosis score. CB was not associated with a higher confidence level in diagnosing SpA based on MRI (<jats:italic>p<\/jats:italic> = 0.07), whereas SpA diagnosis was associated with a higher score (<jats:italic>r<\/jats:italic> = 0.61, <jats:italic>p<\/jats:italic> &lt; 0.001). Both CB (phi = 0.13, <jats:italic>p<\/jats:italic> = 0.02) and SpA diagnosis (phi = 0.23, <jats:italic>p<\/jats:italic> &lt; 0.001) were significantly associated with a positive ASAS criterion for sacroiliitis. In non-SpA patients with CB, number of children (<jats:italic>p<\/jats:italic> = 0.001) was an independent predictor of sclerosis score, while birth method yielded no significant effect (<jats:italic>p<\/jats:italic> = 0.75).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Pregnancy\/CB has no impact on long-term BME on SIJ, however, may cause long-term subchondral sclerosis\u2014similar to SpA-associated sclerosis. Number of children is positively correlated with SIJ sclerosis. Birth method yields no effect on SIJ sclerosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00256-020-03700-9","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T01:02:36Z","timestamp":1611190956000},"page":"1617-1628","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Influence of pregnancy\/childbirth on long-term bone marrow edema and subchondral sclerosis of sacroiliac joints"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9273-0032","authenticated-orcid":false,"given":"Christoph","family":"Germann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Kroismayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Brunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian W. 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