Factors associated with rheumatologist involvement during pregnancy in women with axSpA
| % Visiting a rheumatologist during pregnancy | Crude OR (95% CI) | Adjusted OR (95% CI) | |
| Maternal age at LMP (years) | |||
| 18–24 | 8.7 | 0.99 (0.58 to 1.71) | 2.42 (0.83 to 7.04) |
| 25–34 | 8.7 | Ref | Ref |
| ≥35–44 | 9.8 | 1.14 (0.85 to 1.53) | 1.13 (0.79 to 1.63) |
| Region | |||
| Northeast | 11.9 | Ref | Ref |
| North central | 7.8 | 0.63 (0.40 to 0.99) | 0.66 (0.38 to 1.16) |
| South | 8.1 | 0.67 (0.46 to 0.98) | 0.71 (0.44 to 1.14) |
| West | 11.6 | 1.00 (0.64 to 1.58) | 1.06 (0.60 to 1.87) |
| Employment status of primary beneficiary | |||
| Active full-time | 9.8 | 1.29 (0.62 to 2.70) | 1.78 (0.65 to 4.84) |
| Active part-time/retirees | 7.8 | Ref | Ref |
| Other/unknown* | 7.2 | 0.93 (0.42 to 2.03) | 1.29 (0.45 to 3.74) |
| Health plan type | |||
| Health maintenance organisation | 12.6 | 1.86 (1.18 to 2.92) | 1.91 (1.09 to 3.36) |
| Preferred provider organisation | 7.2 | Ref | Ref |
| Consumer directed/high deductible health plan | 12.2 | 1.78 (1.29 to 2.45) | 1.75 (1.18 to 2.60) |
| Other† | 10.1 | 1.45 (0.86 to 2.42) | 1.14 (0.59 to 2.21) |
| Relationship to beneficiary | |||
| Primary beneficiary | 8.9 | Ref | Ref |
| Spouse | 9.8 | 1.11 (0.83 to 1.48) | 1.06 (0.74 to 1.52) |
| Other dependent | 7.0 | 0.77 (0.44 to 1.37) | 0.34 (0.11 to 1.11) |
| Pre-existing comorbidities‡ | 11.2 | 1.29 (0.79 to 2.09) | 0.80 (0.43 to 1.51) |
| During the 90 days before LMP | |||
| OB and PCP visits | |||
| No OB/PCP visit | 8.3 | Ref | Ref |
| OB visit but no PCP visit | 6.3 | 0.75 (0.46 to 1.21) | 0.82 (0.46 to 1.47) |
| PCP visit but no OB visit | 10.0 | 1.23 (0.89 to 1.71) | 1.52 (1.02 to 2.26) |
| OB and PCP visits | 13.5 | 1.73 (1.15 to 2.62) | 1.51 (0.89 to 2.56) |
| Rheumatologist visits and biological claims | |||
| None | 5.2 | Ref | Ref |
| Rheumatologists visit only | 68.1 | 39.14 (25.28 to 60.61) | 43.84 (27.45 to 70.04) |
| Biological claims only | 33.3 | 9.15 (3.62 to 23.10) | 9.09 (3.50 to 23.56) |
| Both | 100 | Not estimable | Not estimable |
The multivariable logistic models were adjusted for demographic and clinical covariates (maternal age, region, employment status of beneficiary, health plan type, relationship to beneficiary and pre-existing comorbidities) and healthcare use in the baseline period (OB and PCP visits, rheumatologist visits and biologics use).
*Other/unknown includes long-term disability, COBRA continuee, surviving spouse/dependent and other/unknown.
†Other includes basic, comprehensive, EPO, POS and POS with capitation.
‡From inpatient/outpatient claims in the 90 days prior to LMP, calculated using Quan’s comorbidity index.
axSpA, axial spondyloarthritis; LMP, last menstrual period; OB, obstetrician; PCP, primary care physician; ref, reference.