{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:49:52Z","timestamp":1782125392623,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["18K12134"],"award-info":[{"award-number":["18K12134"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["20K08427"],"award-info":[{"award-number":["20K08427"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP20ck0106633"],"award-info":[{"award-number":["JP20ck0106633"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP23mk0121259"],"award-info":[{"award-number":["JP23mk0121259"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["20KC2009"],"award-info":[{"award-number":["20KC2009"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23KC2002"],"award-info":[{"award-number":["23KC2002"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) frequently affects women of reproductive age; its treatment requires disease\u2010modifying antirheumatic drugs (DMARDs). Despite the widespread use of biologics and the expected improvement in fertility, real\u2010world studies evaluating reproductive outcomes in women with RA are limited. We aimed to compare reproductive outcomes in women with and without RA using a nationwide claims database in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study analyzed 231\u2009427 women (aged 20\u201338\u2009years) from the JMDC Claims Database. After propensity score matching, we compared 262 women with RA (defined by diagnosis and DMARDs prescription) to 1310 matched controls without RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the 5\u2010year follow\u2010up, women with RA showed significantly lower delivery rates than the matched controls (19.0% vs. 28.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Kaplan\u2013Meier analysis demonstrated a significantly longer time to delivery in the RA group than in the non\u2010RA group (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0014). In the subgroup analysis, the mean time to delivery was longer in patients with RA and methotrexate use (38.1\u2009months) than in those without methotrexate use (33.7\u2009months) and in non\u2010RA controls (32.2\u2009months). Despite modern RA treatments, including biologics, women with RA have significantly lower delivery rates and longer delivery times than those without RA. This study was limited by potentially unmeasured confounding factors and the lack of certain data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the need for proactive reproductive health management in women with RA and emphasize the importance of collaboration between rheumatologists and obstetricians to provide optimal care for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70296","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T04:44:45Z","timestamp":1749098685000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Five\u2010Year Delivery Rate and Time to Delivery Among Women With and Without Rheumatoid Arthritis: A Real\u2010World Analysis Using a Nationwide Claims Database in Japan"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3261-8828","authenticated-orcid":false,"given":"Hiroshi","family":"Ohtsu","sequence":"first","affiliation":[{"name":"Faculty of Health Data Science Juntendo University  Tokyo Japan"},{"name":"Department of Clinical Pharmacology and Regulatory Science Graduate School of Medicine, Juntendo University  Tokyo Japan"},{"name":"Institute for Medical Regulatory Science, Organization for University Research Initiatives, Waseda University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8904-9043","authenticated-orcid":false,"given":"Izumi","family":"Fujioka","sequence":"additional","affiliation":[{"name":"Faculty of Health Data Science Juntendo University  Tokyo Japan"},{"name":"The Japan Drug Information Institute in Pregnancy, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5569-9275","authenticated-orcid":false,"given":"Mikako","family":"Goto","sequence":"additional","affiliation":[{"name":"The Japan Drug Information Institute in Pregnancy, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinatsu","family":"Takai","sequence":"additional","affiliation":[{"name":"The Japan Drug Information Institute in Pregnancy, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Yonemoto","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine University of Toyama  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Sase","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Regulatory Science Graduate School of Medicine, Juntendo University  Tokyo Japan"},{"name":"Institute for Medical Regulatory Science, Organization for University Research Initiatives, Waseda University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Murashima","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Applied Immunology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102020\u2010219547"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.123919"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000046"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq458"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102014\u2010205383"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30327"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24914"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102018\u2010214619"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb1609216"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.10136"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.je20090066"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.422"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol\u20102020\u2010316198"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4444"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5213"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.04.103"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000058"},{"key":"e_1_2_13_19_1","unstructured":"Ministry 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