Weng Ian Che,Luigi Annicchiarico,Laura Andreoli,Olof Stephansson,Marie Holmqvist,Karin Hellgren
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引用次数: 0
Abstract
OBJECTIVE
To assess risks of adverse pregnancy outcomes (APO) in a contemporary cohort of women with systemic sclerosis (SSc) in relation to the timing of SSc diagnosis and by parity.
METHODS
From the nationwide Swedish Medical Birth Register, we assembled pregnancies with births in women with SSc and in comparator women from the general population 1998-2021. We classified pregnancies according to the timing of SSc diagnosis at birth: post-SSc; after SSc diagnosis (n=94), and pre-SSc; 0-3 years (n=39) or >3 years (n=839) before diagnosis of SSc. We used regression models estimating relative risks (RR) of APO in post-SSc, and odds ratios (OR) in pre-SSc pregnancies with 95% confidence interval (CI), respectively.
RESULTS
For post-SSc pregnancies, RR of preeclampsia (3.8; 1.8-7.8), preterm birth (3.3; 1.8-6.1), and caesarean delivery (2.5; 1.8-3.5) were increased. By contrast, there were no indications of increased proportions of maternal or neonatal death, nor stillbirth. Stratifying on parity, risks were considerably higher among primiparous post-SSc women; RR of preeclampsia (7.5; 3.5-16.1) and of preterm birth (5.1; 2.5-10.5). We also noted increased odds of APO in pre-SSc pregnancies, with the highest estimates in the 0-3 years pre-SSc pregnancies.
CONCLUSION
Contemporary women with SSc displayed markedly increased risks of several APO after SSc diagnosis; the risk of some APO was already increased before diagnosis, particularly within 3 years. Our findings suggest that both preclinical and overt SSc have a substantial impact on pregnancy outcomes, especially in the first pregnancy, highlighting the importance of specialized care and close monitoring.
期刊介绍:
Arthritis & Rheumatology is the official journal of the American College of Rheumatology and focuses on the natural history, pathophysiology, treatment, and outcome of rheumatic diseases. It is a peer-reviewed publication that aims to provide the highest quality basic and clinical research in this field. The journal covers a wide range of investigative areas and also includes review articles, editorials, and educational material for researchers and clinicians. Being recognized as a leading research journal in rheumatology, Arthritis & Rheumatology serves the global community of rheumatology investigators and clinicians.