{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T21:06:53Z","timestamp":1758056813033,"version":"3.44.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Despite increasing rheumatic disease prevalence among female individuals in Ontario, Canada, research is limited on whether this has translated to an increased proportion of pregnancies with rheumatic diseases. This study aimed to assess rheumatic disease rates among pregnant individuals in Ontario, Canada.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using healthcare administrative claims databases from ICES, the proportion of pregnancies with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) from April 2011 to March 2021 were examined. The Mann-Kendall rank correlation test was used to test for trends in overall and individual rheumatic disease rates across the study period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In total, 1,408,100 pregnancies were recorded from fiscal years 2011\u20132020 in Ontario. Of these, 4,392 involved patients with rheumatic diseases. The overall rheumatic disease rate among pregnant individuals increased by 24% from 28.3 to 35.2 pregnancies per 10,000 over the study period (p\u2009=\u20090.0157). RA rates increased 22% from 11.1 to 13.5 per 10,000 (p\u2009=\u20090.0056), while PsA rates increased 111% from 0.9 to 1.9 per 10,000 (p\u2009=\u20090.0157). SLE, AS, and multiple rheumatic disease rates did not increase significantly.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The proportion of individuals with rheumatic diseases pursuing pregnancy in Ontario has increased, perhaps aided by advancements in disease diagnostics and treatment strategies. Further research is needed to link antirheumatic drug safety to pregnancy outcomes and explore other factors that may influence pregnancy rates among this patient population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0332374","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T17:24:06Z","timestamp":1757957046000},"page":"e0332374","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world trends in rheumatic disease rates among pregnancies in Ontario, Canada: A repeated cross-sectional study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-1466","authenticated-orcid":true,"given":"Shenthuraan","family":"Tharmarajah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zain","family":"Abideen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swaleh","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara J.T.","family":"Guilcher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"McCarthy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dharini","family":"Mahendira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3842-213X","authenticated-orcid":true,"given":"Howard","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Tadrous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"issue":"1","key":"pone.0332374.ref001","doi-asserted-by":"crossref","first-page":"21","DOI":"10.22631\/rr.2017.69997.1037","article-title":"Prevalence of inflammatory rheumatic diseases in a rheumatologic outpatient clinic: analysis of 12626 cases","volume":"3","author":"M Jokar","year":"2018","journal-title":"Rheum Res"},{"issue":"17","key":"pone.0332374.ref002","first-page":"1152","article-title":"Severe organ manifestations in rheumatic diseases","volume":"146","author":"F G\u00fcnther","year":"2021","journal-title":"Dtsch Med Wochenschr"},{"issue":"1","key":"pone.0332374.ref003","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3390\/diagnostics12010067","article-title":"Organ manifestation and systematic organ screening at the onset of inflammatory rheumatic diseases","volume":"12","author":"T Hoffmann","year":"2021","journal-title":"Diagnostics (Basel)"},{"issue":"3","key":"pone.0332374.ref004","article-title":"All-cause mortality in systemic rheumatic diseases under treatment compared with the general population, 2015-2019","volume":"7","author":"V-K Bournia","year":"2021","journal-title":"RMD Open"},{"issue":"12","key":"pone.0332374.ref005","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1177\/0961203319877258","article-title":"Pregnancy outcomes in women with rheumatic diseases: a real-world observational study in Japan","volume":"28","author":"E Sugawara","year":"2019","journal-title":"Lupus"},{"issue":"3","key":"pone.0332374.ref006","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3899\/jrheum.180226","article-title":"Does rheumatoid arthritis really improve during pregnancy? 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