Adverse Pregnancy Outcomes in Sjogren's Disease Compared to Controls: An Interdisciplinary Approach with Maternal-Fetal Medicine.

Abstract

Objectives: Outside of the association of SS-A antibody with congenital heart block, little is known about adverse maternal and neonatal outcomes, in patients with Sjogren's disease (SjD). Our study involved collaboration with maternal-fetal medicine (MFM).

Methods: A retrospective cohort study of pregnant patients: SjD patients were matched 1:3 with non-SjD controls. SjD patients were included by meeting the 2016 ACR/EULAR Criteria or by a rheumatologist diagnosis. Exclusion criteria were concurrent autoimmune disease or related antibodies. A composite of grouped outcomes was utilized and verified by MFM specialists. The primary outcome was adverse pregnancy outcome (APO) between the two groups. Statistical analysis was performed using a two-sample t -test and Fisher's exact test.

Results: 48 patients were included: 12 SjD patients and 36 controls. APO was significantly increased in SjD with one preterm birth, one fetal growth restriction, and one limb anomaly; non-SjD had one cardiac anomaly. There were no cases of CHB. SjD patients were more likely to be delivered by cesarean delivery.

Conclusion: There was an increased risk of APO in SjD patients compared with controls. No significant difference in neonatal outcomes was found. We speculate that placental pathology may play a role in pathophysiology and future studies should be performed.

Key points: There was an increased risk of APO in SjD patients compared with controls.No significant difference in neonatal outcomes was found.We speculate that placental pathology may play a role in pathophysiology, prompting future studies.