A HIGH PROPORTION OF WOMEN WITH AXIAL SPONDYLOARTHRITIS BREASTFED IN NORWEGIAN COHORT

Background: There is sparse research done on the topic of breastfeeding in women with axial spondyloarthritis (axSpA). Previous research has focused on the use of medication during lactation. Objectives: Our aim was to obtain more knowledge about variables affecting breastfeeding for women with axSpA. Methods: The current prospective study used data from the nationwide quality register RevNatus, including 350 patients with axSpA in a total of 417 pregnancies. The breastfeeding and non-breastfeeding women were compared at follow up visits six weeks, six months and twelve months postpartum. The groups were compared in regard to demographic and obstetric data, disease characteristics, medical treatment and health related quality of life. Information on breastfeeding was registered at least once during the follow-up postpartum. Results: The proportion of women with axSpA breastfeeding at the postpartum follow ups was 86% at six weeks, 70% at six months, and 38% at twelve months. At inclusion the mean age was 31 years, mean disease duration was 4,5 years, and 53% had previous live births. Mean age was higher for the breastfeeding group at six weeks and twelve months postpartum. The use of tobacco was more common for the non-breastfeeding group at all follow ups. Mean BMI was higher for the non-breastfeeding women at the six month follow up. There was also a larger proportion of obesity among these women. A larger proportion of the non-breastfeeding group had delivered with cesarean section (CS). ASDAS-CRP was higher for the non-breastfeeding group at six weeks and six months, and BASDAI was higher for the same group at six months. VAS pain scores were higher for the non-breastfeeding group at six weeks and six months. The same was the case for VAS fatigue at six months. The use of methotrexate and secukinumab was more common among those not breastfeeding av six months. The use of TNF-inhibitors varied from 30% at six weeks to 51% at six months and 56% at twelve months. Conclusion: Our study showed that a large proportion of women with axSpA were breastfeeding at six weeks and six months after giving birth. The non-breastfeeding group was younger. A significantly larger proportion of the non-breastfeeding women had given birth with CS. The women not breastfeeding had higher disease activity according to ASDAS-CRP and BASDAI at all postpartum follow ups. They also reported higher levels of pain, fatigue and total disease burden. Being able to control the disease in a better way might increase the chance that these patients breastfeed. Table 1. Comparing breastfeeding and non-breastfeeding women with axSpA at six weeks postpartum, reported as n (%) unless specified as mean (SD ) n (B/N-B ) Breastfeeding (n= 347 ) Non-breastfeeding (n= 59 ) P-value Age, years, mean (SD ) 347/59 31,9 (4,3) 30,5 (4,7) 0,027* ≥ 35 years 93 (26,8) 10 (16,9) 0,1 BMI, mean (SD ) 318/50 26,6 (4,5) 27,8 (5,4) 0,08 Overweight (BMI ≥25,0) 189 (59,4) 32 (64,0) 0,5 Obesity (BMI ≥30,0) 64 (20,1) 15 (30,0) 0,1 Tobacco use 315/53 11 (3,5) 5 (9,4) 0,06 CRP, mean (SD ) 290/45 5,5 (8,0) 6,0 (9,5) 0,7 BASDAI, mean (SD ) 277/45 3,0 (2,3) 3,6 (2,4) 0,1 BASDAI ≥ 4 85 (30,7) 19 (42,2) 0,1 ASDAS-CRP, mean (SD ) 201/36 2,2 (1,0) 2,6 (1,0) 0,030 * ASDAS-CRP ≥ 1,3 161 (80,1) 34 (94,4) 0,038 * VAS pain, mean (SD ) 291/50 31,6 (26,4) 41,0 (29,7) 0,029 * VAS fatigue, mean (SD ) 281/48 36,9 (29,4) 43,5 (29,2) 0,1 VAS total, mean (SD ) 292/49 35,8 (27,7) 46,5 (27,8) 0,011 * Prematurity 347/59 17 (4,9) 7 (11,9) 0,07 Cesarean section 347/59 70 (20,2) 24 (40,7) <0,001 * Preeclampsia 338/57 21 (6,2) 4 (7,0) 0,8 Contraception 237/38 83 (35,2) 22 (57,9) 0,007 * csDMARDs 347/59 22 (6,3) 4 (6,8) 0,8 TNF-inhibitors 347/59 106 (30,5) 17 (28,8) 0,8 B= breastfeeding, NB= non-breastfeeding, BMI= Body Mass Index, VAS= Visual Analogue Scale, BASDAI= Bath Ankolysing Spondylitis Disease Activity Index, ASDAS= Ankylosing Spondylitis Disease Activity Score, CRP= C-reactive protein, Preeclampsia= Preeclampsia/Eclampsia/HELLP-syndrome, csDMARDs= conventional synthetic disease-modifying anti-rheumatic drugs, including sulfasalazine and methotrexate, TNF-inhibitors= tumor necrosis factor inhibitors. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared. DOI: 10.1136/annrheumdis-2024-eular.1558 Keywords: Quality of life, Nursing Citation: , volume 83, supplement 1, year 2024, page 1740Session: Spondyloarthritis (Publication Only)

Quality of life, Nursing