{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T16:59:53Z","timestamp":1785689993422,"version":"3.56.0"},"reference-count":13,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006315","name":"ReumaNederland","doi-asserted-by":"publisher","award":["LLP-26"],"award-info":[{"award-number":["LLP-26"]}],"id":[{"id":"10.13039\/501100006315","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,6,17]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To describe parenting disability postpartum in patients with rheumatoid arthritis (RA) using the Parenting Disability Index and to determine early in pregnancy which patients will face parenting problems postpartum.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were collected from a prospective study on pregnancy and RA (Pregnancy induced Amelioration of Rheumatoid Arthritis study). Postpartum visits were performed at 6, 12 and 26\u00a0weeks after delivery. Domains causing parenting difficulties were identified. A multivariate logistic regression model to identify which patients develop parenting disabilities postpartum with patient characteristics in the first trimester as covariates was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>148 patients were eligible for this study. The domains carrying, hygiene, feeding, getting up and down, and household\/shopping were frequently scored as difficult. Maintaining discipline, taking care of the children when sick, listening and having other children over caused the least problems. 30.1% of patients with RA report low parenting disability, 30.9% reports intermediate disability and 39.0% reports high disability. Patients with a low Health Assessment Questionnaire (HAQ)-score in the first trimester (OR 9.2, 95% CI 3.0 to 27.7, p&lt;0.001) and low disease activity in the first trimester (Disease Activity Score 28-joint count C reactive protein&lt;3.2) (OR 4.8, 95% CI 1.8 to 12.9, p=0.002) were likely to report low parenting disability postpartum. Patients with a longer disease duration (OR 0.87, 95% CI 0.79 to 0.95, p=0.003) were less likely to report low parenting disability postpartum. A high HAQ-score in the first trimester (OR 4.54, 95% CI 1.99 to 10.34, p&lt;0.001) and erosive disease (OR 2.32, 95% CI 1.00 to 5.35, p=0.049) increased the risk of high parenting disability postpartum.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Physical domains of parenting postpartum are most commonly affected in patients with RA. When counselling patients with RA, a HAQ-score in the first trimester is the most reliable marker to identify patients that develop parenting disability after delivery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001276","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T05:47:32Z","timestamp":1594273652000},"page":"e001276","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Parenting problems postpartum can be detected early in pregnancy in patients with rheumatoid arthritis"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7724-7712","authenticated-orcid":false,"given":"Hieronymus T W","family":"Smeele","sequence":"first","affiliation":[{"name":"Rheumatology, Erasmus MC, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael A","family":"de Man","sequence":"additional","affiliation":[{"name":"Rheumatology, Erasmus MC, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"R\u00f6der","sequence":"additional","affiliation":[{"name":"Rheumatology, Erasmus MC, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetty","family":"Wintjes","sequence":"additional","affiliation":[{"name":"Rheumatology, Erasmus MC, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J M W","family":"Hazes","sequence":"additional","affiliation":[{"name":"Rheumatology, Erasmus MC, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radboud J E M","family":"Dolhain","sequence":"additional","affiliation":[{"name":"Rheumatology, Erasmus MC, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"2025090312134790000_6.2.e001276.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(98)00136-0"},{"key":"2025090312134790000_6.2.e001276.2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s41927-018-0029-4","article-title":"Identifying the unmet information and support needs of women with autoimmune rheumatic diseases during pregnancy planning, pregnancy and early parenting: mixed-methods study","volume":"2","author":"Phillips","year":"2018","journal-title":"BMC Rheumatol"},{"key":"2025090312134790000_6.2.e001276.3","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1002\/acr2.11069","article-title":"\u201cr\/Thritis\u201d, pregnancy, and parenting: a qualitative descriptive study of reddit forums to explore information needs and concerns of women with rheumatoid arthritis","volume":"1","author":"Chew","year":"2019","journal-title":"ACR Open Rheumatol"},{"key":"2025090312134790000_6.2.e001276.4","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000044"},{"key":"2025090312134790000_6.2.e001276.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.10990"},{"key":"2025090312134790000_6.2.e001276.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.24003"},{"key":"2025090312134790000_6.2.e001276.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"2025090312134790000_6.2.e001276.8","doi-asserted-by":"publisher","DOI":"10.1007\/BF02032335"},{"key":"2025090312134790000_6.2.e001276.9","doi-asserted-by":"crossref","first-page":"276","DOI":"10.11613\/BM.2012.031","article-title":"Interrater reliability: the kappa statistic","volume":"22","author":"McHugh","year":"2012","journal-title":"Biochem Med (Zagreb)"},{"key":"2025090312134790000_6.2.e001276.10","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002864"},{"key":"2025090312134790000_6.2.e001276.11","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199909)42:9<1854::AID-ANR9>3.0.CO;2-F"},{"key":"2025090312134790000_6.2.e001276.12","first-page":"333","article-title":"Efficacy of biologic agents in improving the Health Assessment Questionnaire (HAQ) score in established and early rheumatoid arthritis: a meta-analysis with indirect comparisons","volume":"32","author":"Barra","year":"2014","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312134790000_6.2.e001276.13","doi-asserted-by":"crossref","first-page":"81","DOI":"10.24095\/hpcdp.33.2.04","article-title":"McGill early arthritis research G. Parenting disability, parenting stress and child behaviour in early inflammatory arthritis","volume":"33","author":"Zelkowitz","year":"2013","journal-title":"Chronic Dis Inj Can"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2020-001276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:13:52Z","timestamp":1756926832000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2020-001276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,7,8]]},"published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1136\/rmdopen-2020-001276"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2020-001276","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]}}}