Pregnancy outcomes in connective tissue diseases: a 30-year study of 465 cases from a single-center Spanish registry with insights on hydroxychloroquine use.

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2025-01-01
Cristiana Sieiro Santos, José Ordás Martínez, Clara Moriano Morales, Carolina Alvarez Castro, Elvira Díez Álvarez
{"title":"Pregnancy outcomes in connective tissue diseases: a 30-year study of 465 cases from a single-center Spanish registry with insights on hydroxychloroquine use.","authors":"Cristiana Sieiro Santos, José Ordás Martínez, Clara Moriano Morales, Carolina Alvarez Castro, Elvira Díez Álvarez","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Pregnancy in women with connective tissue diseases (CTDs), including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), primary Sjögren's syndrome (pSS), and undifferentiated connective tissue disease (UCTD), poses significant risks for adverse outcomes. Evaluating these risks and outcomes is essential to improve maternal and fetal health.</p><p><strong>Objectives: </strong>This study aimed to assess pregnancy outcomes in patients with CTDs, identify factors associated with adverse outcomes, and evaluate the protective effects of hydroxychloroquine (HCQ) treatment.</p><p><strong>Methods: </strong>A study covering the period from 1990 to 2022 was conducted. Data were collected from medical records of childbearing-age women with SLE, SSc, pSS, and UCTD who were under care at our clinic. Obstetric, maternal, and fetal outcomes were analyzed across different diagnoses. Statistical analyses were performed to identify associations between disease activity, treatments, and pregnancy outcomes.</p><p><strong>Results: </strong>A total of 295 patients (125 with SLE, 50 with SSc, 80 with pSS, and 40 with UCTD) and 465 pregnancies were included. The mean age at first pregnancy was 29.1±9.1 years. Pregnancy loss occurred in 21% of cases, while 77% resulted in live births. Adverse outcomes included preterm delivery (8%), postpartum hemorrhage (6%), and preeclampsia (5%). SLE diagnosis (OR 1.5, 95% CI [1.1-4.8], p = 0.03), double/triple antiphospholipid antibody (APL) positivity (OR 2.3, 95% CI [1.1-3.9], p = 0.04), and active disease (OR 3.4, 95% CI [1.8-5.2], p = 0.004) were identified as risk factors for adverse pregnancy outcomes. HCQ treatment demonstrated a protective effect (OR 0.34, 95% CI [0.05-0.72], p = 0.0004).</p><p><strong>Conclusion: </strong>Two-thirds of pregnancies in women with CTDs resulted in live births, though SLE was associated with significantly higher risks. Active disease during pregnancy emerged as a major risk factor. Importantly, the use of HCQ was associated with a notable reduction in these risks, underscoring its protective role in improving pregnancy outcomes. These findings highlight the critical importance of preconception counseling, careful disease management, and the proactive use of HCQ to minimize complications and optimize outcomes in pregnancies complicated by CTDs.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"29-36"},"PeriodicalIF":1.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ARP Rheumatology","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Pregnancy in women with connective tissue diseases (CTDs), including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), primary Sjögren's syndrome (pSS), and undifferentiated connective tissue disease (UCTD), poses significant risks for adverse outcomes. Evaluating these risks and outcomes is essential to improve maternal and fetal health.

Objectives: This study aimed to assess pregnancy outcomes in patients with CTDs, identify factors associated with adverse outcomes, and evaluate the protective effects of hydroxychloroquine (HCQ) treatment.

Methods: A study covering the period from 1990 to 2022 was conducted. Data were collected from medical records of childbearing-age women with SLE, SSc, pSS, and UCTD who were under care at our clinic. Obstetric, maternal, and fetal outcomes were analyzed across different diagnoses. Statistical analyses were performed to identify associations between disease activity, treatments, and pregnancy outcomes.

Results: A total of 295 patients (125 with SLE, 50 with SSc, 80 with pSS, and 40 with UCTD) and 465 pregnancies were included. The mean age at first pregnancy was 29.1±9.1 years. Pregnancy loss occurred in 21% of cases, while 77% resulted in live births. Adverse outcomes included preterm delivery (8%), postpartum hemorrhage (6%), and preeclampsia (5%). SLE diagnosis (OR 1.5, 95% CI [1.1-4.8], p = 0.03), double/triple antiphospholipid antibody (APL) positivity (OR 2.3, 95% CI [1.1-3.9], p = 0.04), and active disease (OR 3.4, 95% CI [1.8-5.2], p = 0.004) were identified as risk factors for adverse pregnancy outcomes. HCQ treatment demonstrated a protective effect (OR 0.34, 95% CI [0.05-0.72], p = 0.0004).

Conclusion: Two-thirds of pregnancies in women with CTDs resulted in live births, though SLE was associated with significantly higher risks. Active disease during pregnancy emerged as a major risk factor. Importantly, the use of HCQ was associated with a notable reduction in these risks, underscoring its protective role in improving pregnancy outcomes. These findings highlight the critical importance of preconception counseling, careful disease management, and the proactive use of HCQ to minimize complications and optimize outcomes in pregnancies complicated by CTDs.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.20
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信