{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:44:36Z","timestamp":1777045476548,"version":"3.51.4"},"reference-count":78,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>During pregnancy, many diseases are correlated with different adverse outcomes. In turn, pregnancy affects the body, leading to increased disease susceptibility. This interplay between diseased states and pregnancy outcomes is illustrated in the effect of the chronic autoimmune disorder, rheumatoid arthritis (RA), and the adverse outcome, preterm birth (PTB). RA is a systemic disorder characterized by inflammation of the joints and other body organs. Joint pain and swelling are the most prominent manifestations of RA during pregnancy. However, the exact role of RA on PTB among pregnant women has yet to be established. This review highlighted the immunologic mechanisms involved in PTB in pregnant patients with RA. The immune cell population in pregnant women with RA exhibited higher activity of macrophages, dendritic cells, neutrophils, helper T (Th) 1 cells, and V\u03b41 cells, but lower activity of CD4\u00a0+\u00a0CD25<jats:sup>high<\/jats:sup> T regulatory (CD24\u00a0+\u00a0CD25<jats:sup>high<\/jats:sup> T<jats:sub>reg<\/jats:sub>), Th2, and V\u03b42 cells. Increased pro\u2010inflammatory cytokines IL\u20106, TNF\u2010\u03b1, and IFN\u2010\u03b3 and decreased anti\u2010inflammatory cytokines IL\u201012 and IL\u201010 are also exhibited by pregnant patients with RA. This review also discussed factors that may predict the risk of PTB in RA. These include disease activity and severity of RA, laboratory parameters (cytokines and immune cell population), and sociodemographic factors such as ethnicity, smoking, alcohol intake, and the level of education. Current findings on the underlying immunological mechanisms of RA can help identify possible strategies to prevent PTB.<\/jats:p>","DOI":"10.1111\/aji.13661","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:23:40Z","timestamp":1669854220000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Rheumatoid arthritis and the risk of preterm birth"],"prefix":"10.1111","volume":"89","author":[{"given":"Robbi Miguel G.","family":"Falcon","sequence":"first","affiliation":[{"name":"College of Medicine University of the Philippines Manila  Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renne Margaret U.","family":"Alcazar","sequence":"additional","affiliation":[{"name":"College of Medicine University of the Philippines Manila  Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alric V.","family":"Mondragon","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Department of Medicine University of the Philippines\u2010Philippine General Hospital  Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester G.","family":"Penserga","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine University of the Philippines\u2010Philippine General Hospital  Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ourlad Alzeus G.","family":"Tantengco","sequence":"additional","affiliation":[{"name":"Career Incentive Program Department of Science and Technology \u2010 Science Education Institute  Taguig Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"23","article-title":"Management of rheumatoid arthritis during pregnancy: challenges and solutions","volume":"8","author":"Krause ML","year":"2016","journal-title":"Open Access Rheumatol"},{"issue":"15","key":"e_1_2_7_3_1","article-title":"Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies","volume":"6","author":"Guo Q","year":"2018","journal-title":"Bone Res"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2010.10.001"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10153289"},{"issue":"9","key":"e_1_2_7_6_1","first-page":"1814","article-title":"The prevalence of rheumatic diseases in a Filipino urban population: a WHO\u2010ILAR COPCORD Study. World Health Organization. International League of Associations for Rheumatology. Community Oriented Programme for the Control of the Rheumatic Diseases","volume":"24","author":"Dans L","year":"1997","journal-title":"J Rheumatol"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.575197"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker302"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199906)42:6<1219::AID-ANR19>3.0.CO;2-G"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24003"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-010-1643-7"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12948-016-0048-x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.2010.00836.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180226"},{"issue":"20","key":"e_1_2_7_15_1","first-page":"3358","article-title":"Maternal cytokines and disease severity influence pregnancy outcomes in women with rheumatoid arthritis","volume":"29","author":"Atta DS","year":"2016","journal-title":"J Matern\u2010Fetal Neonatal Med"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780260915"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745505716661724"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcreue.2018.10.001"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2018.08.027"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncprheum0044"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1269-1"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2017.68945"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejr.2021.10.005"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23730"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar1977"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X14551568"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140583"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-006-0073-3"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38247"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/14397595.2019.1661592"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3939-4"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-016-0431-z"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780340714"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009748309102886"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24914"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.2147\/OARRR.S315867"},{"issue":"1","key":"e_1_2_7_37_1","first-page":"9","article-title":"High rate of preterm birth in pregnancies complicated by rheumatoid arthritis","volume":"31","author":"Langen ES","year":"2014","journal-title":"Am J Perinatol"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1498835"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23621"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key053"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38874"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/345727"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.105262"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209322"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-019-0351-2"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.075283"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/09629350020027609"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202539"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.604866"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.2007.00506.x"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23907"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-016-0925-1"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gav027"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.59.7.555"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar1447"},{"key":"e_1_2_7_56_1","first-page":"6398520","article-title":"Association of oxidative stress on pregnancy","author":"Tobo\u0142a\u2010Wr\u00f3bel K","year":"2020","journal-title":"Oxid Med Cell Longev"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-04076-0"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-016-1172-1"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2017.00241"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.03166"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2018.07.009"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab894"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4410"},{"key":"e_1_2_7_64_1","doi-asserted-by":"crossref","unstructured":"Chiara GerardiM CrisafulliF Garc\u00eda\u2010FernandezA et\u00a0al.Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis.2022;13:887462.","DOI":"10.3389\/fphar.2022.887462"},{"key":"e_1_2_7_65_1","doi-asserted-by":"crossref","unstructured":"CostanzoG FirinuD LosaF DeiddaM BarcaMP Giacco Sdel.Baricitinib exposure during pregnancy in rheumatoid arthritis.2020;12:1759720X19899296.","DOI":"10.1177\/1759720X19899296"},{"issue":"6","key":"e_1_2_7_66_1","first-page":"869","article-title":"Risk of preterm delivery and small\u2010for\u2010gestational\u2010age births in women with autoimmune disease using biologics before or during pregnancy: a population\u2010based cohort study","volume":"77","author":"Tsao NW","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2010.02239.x"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30327"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130074"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.56.8.463"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/tog.12585"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56040178"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq202"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4230"},{"key":"e_1_2_7_75_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-89618-1"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000414"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab598"},{"key":"e_1_2_7_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2021.08.006"},{"key":"e_1_2_7_79_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22244"}],"container-title":["American Journal of Reproductive Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.13661","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aji.13661","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.13661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T02:16:57Z","timestamp":1692325017000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aji.13661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,15]]},"references-count":78,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/aji.13661"],"URL":"https:\/\/doi.org\/10.1111\/aji.13661","archive":["Portico"],"relation":{},"ISSN":["1046-7408","1600-0897"],"issn-type":[{"value":"1046-7408","type":"print"},{"value":"1600-0897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,15]]},"assertion":[{"value":"2022-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13661"}}