CHANGES IN LEVELS OF IGM RF AND ALPHA-2 PAG CORRELATE WITH INCREASED DISEASE-ACTIVITY IN RHEUMATOID-ARTHRITIS DURING THE PUERPERIUM

In this prospective study of 24 pregnant patients with rheumatoid arth ritis, quiescent disease activity in 2 1 patients (88%) during gestati on was followed by more active disease in the puerperium in 19 patient s (79%). Increased disease activity was reflected in a deterioration i n manual dexterity and this was found to correlate with a post-partum rise in IgM rheumatoid factor (IgM RF) (r = 0.86) and a post-partum de cline in pregnancy associated alpha-2 glycoprotein (PAG) (r = 0.44). T he increase in IgM RF also correlated with increased disease activity measured by a visual analogue scale (r = 0.44). Changes in IgA RF were not observed. These results suggest that PAG and IgM RF could contrib ute to the modulation and pathogenesis of rheumatoid arthritis during pregnancy.