Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.

Background: Pregnancy in systemic sclerosis (SSc) patients is no more an infrequent event as it used to be, but literature data on pregnancy outcomes in women with SSc are scarce. The rate of preterm deliveries and intrauterine growth restriction (IUGR) seems to be increased, while the risk of misca...

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Autores: Barilaro, Giuseppe, Castellanos, Aleida, Gomez Ferreira, Înes, Lledó, Gema, Della Rocca, Carlo, Fernandez Blanco, Lorena, Cervera i Segura, Ricard, 1960-, Baños, Núria, Figueras Retuerta, Francesc, Espinosa Garriga, Gerard
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/201562
Acesso em linha:https://hdl.handle.net/2445/201562
Access Level:acceso abierto
Palavra-chave:Esclerodèrmia
Lupus eritematós
Síndrome antifosfolipídica
Malalties autoimmunitàries
Embaràs
Scleroderma (Disease)
Lupus erythematosus
Antiphospholipid syndrome
Autoimmune diseases
Pregnancy
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spelling Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.Barilaro, GiuseppeCastellanos, AleidaGomez Ferreira, ÎnesLledó, GemaDella Rocca, CarloFernandez Blanco, LorenaCervera i Segura, Ricard, 1960-Baños, NúriaFigueras Retuerta, FrancescEspinosa Garriga, GerardEsclerodèrmiaLupus eritematósSíndrome antifosfolipídicaMalalties autoimmunitàriesEmbaràsScleroderma (Disease)Lupus erythematosusAntiphospholipid syndromeAutoimmune diseasesPregnancyBackground: Pregnancy in systemic sclerosis (SSc) patients is no more an infrequent event as it used to be, but literature data on pregnancy outcomes in women with SSc are scarce. The rate of preterm deliveries and intrauterine growth restriction (IUGR) seems to be increased, while the risk of miscarriages is controversial. Moreover, no study compared pregnancy outcomes in SSc with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). We performed a retrospective study to compare the pregnancy and disease outcomes of women with SSc with a cohort of age-matched women with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and healthy controls (HC). Methods: A total of 154 pregnancies from SSc, SLE, APS patients, and HC were prospectively followed at the High-Risk Pregnancy Unit of our center from 2008 to 2019. The primary outcome was a composite endpoint of miscarriages, fetal deaths, intrauterine growth restriction (IUGR), preeclampsia, neonatal deaths, preterm birth, and small-for-gestational-age (SGA) newborns. Single adverse pregnancy outcomes (APO) represented secondary endpoints. SSc activity variations in relation to pregnancy were assessed. Results: The risk of APO was significantly higher in SSc patients compared to HC (60.6% vs 10.0%; OR = 14.42; 95% CI 3.70-56.18, p = 0.001) and SLE patients (60.6% vs 37.5%; OR = 3.56; 95% CI 1.29-9.83, p = 0.014). Compared to HC, women with SSc had an increased frequency of first trimester miscarriage (15% vs 0 %; p = 0.016), preeclampsia (12% vs 0%, p = 0.038), and SGA newborns (21.2% vs 0%; p = 0.003). Preterm deliveries were more frequent in SSc pregnancies in comparison with HC (24.2% vs 5%; OR = 6.08; 95% CI 1.19-31.02, p = 0.036) and SLE patients (24.2% vs 7.5%, OR = 5.68; 95% CI 1.1-29.38, p = 0.038). Disease remained stable in all SSc patients during pregnancy and up to 1 year after delivery. Conclusions: We found an increased risk of APO in our SSc cohort in comparison with HC (with higher rates of miscarriages, preeclampsia, SGA newborns, and preterm deliveries) and SLE patients (presenting a higher rate of preterm deliveries). High-risk multidisciplinary management of SSc pregnant women is highly recommended.BioMed Central2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/201562Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1186/s13075-022-02783-0Arthritis Research & Therapy, 2022, vol. 24, num. 1, p. 91https://doi.org/10.1186/s13075-022-02783-0cc-by (c) Barilaro, Giuseppe et al., 2022https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2015622026-05-27T06:46:51Z
dc.title.none.fl_str_mv Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
title Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
spellingShingle Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
Barilaro, Giuseppe
Esclerodèrmia
Lupus eritematós
Síndrome antifosfolipídica
Malalties autoimmunitàries
Embaràs
Scleroderma (Disease)
Lupus erythematosus
Antiphospholipid syndrome
Autoimmune diseases
Pregnancy
title_short Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
title_full Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
title_fullStr Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
title_full_unstemmed Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
title_sort Systemic sclerosis and pregnancy outcomes: a retrospective study from a single center.
dc.creator.none.fl_str_mv Barilaro, Giuseppe
Castellanos, Aleida
Gomez Ferreira, Înes
Lledó, Gema
Della Rocca, Carlo
Fernandez Blanco, Lorena
Cervera i Segura, Ricard, 1960-
Baños, Núria
Figueras Retuerta, Francesc
Espinosa Garriga, Gerard
author Barilaro, Giuseppe
author_facet Barilaro, Giuseppe
Castellanos, Aleida
Gomez Ferreira, Înes
Lledó, Gema
Della Rocca, Carlo
Fernandez Blanco, Lorena
Cervera i Segura, Ricard, 1960-
Baños, Núria
Figueras Retuerta, Francesc
Espinosa Garriga, Gerard
author_role author
author2 Castellanos, Aleida
Gomez Ferreira, Înes
Lledó, Gema
Della Rocca, Carlo
Fernandez Blanco, Lorena
Cervera i Segura, Ricard, 1960-
Baños, Núria
Figueras Retuerta, Francesc
Espinosa Garriga, Gerard
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Esclerodèrmia
Lupus eritematós
Síndrome antifosfolipídica
Malalties autoimmunitàries
Embaràs
Scleroderma (Disease)
Lupus erythematosus
Antiphospholipid syndrome
Autoimmune diseases
Pregnancy
topic Esclerodèrmia
Lupus eritematós
Síndrome antifosfolipídica
Malalties autoimmunitàries
Embaràs
Scleroderma (Disease)
Lupus erythematosus
Antiphospholipid syndrome
Autoimmune diseases
Pregnancy
description Background: Pregnancy in systemic sclerosis (SSc) patients is no more an infrequent event as it used to be, but literature data on pregnancy outcomes in women with SSc are scarce. The rate of preterm deliveries and intrauterine growth restriction (IUGR) seems to be increased, while the risk of miscarriages is controversial. Moreover, no study compared pregnancy outcomes in SSc with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). We performed a retrospective study to compare the pregnancy and disease outcomes of women with SSc with a cohort of age-matched women with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and healthy controls (HC). Methods: A total of 154 pregnancies from SSc, SLE, APS patients, and HC were prospectively followed at the High-Risk Pregnancy Unit of our center from 2008 to 2019. The primary outcome was a composite endpoint of miscarriages, fetal deaths, intrauterine growth restriction (IUGR), preeclampsia, neonatal deaths, preterm birth, and small-for-gestational-age (SGA) newborns. Single adverse pregnancy outcomes (APO) represented secondary endpoints. SSc activity variations in relation to pregnancy were assessed. Results: The risk of APO was significantly higher in SSc patients compared to HC (60.6% vs 10.0%; OR = 14.42; 95% CI 3.70-56.18, p = 0.001) and SLE patients (60.6% vs 37.5%; OR = 3.56; 95% CI 1.29-9.83, p = 0.014). Compared to HC, women with SSc had an increased frequency of first trimester miscarriage (15% vs 0 %; p = 0.016), preeclampsia (12% vs 0%, p = 0.038), and SGA newborns (21.2% vs 0%; p = 0.003). Preterm deliveries were more frequent in SSc pregnancies in comparison with HC (24.2% vs 5%; OR = 6.08; 95% CI 1.19-31.02, p = 0.036) and SLE patients (24.2% vs 7.5%, OR = 5.68; 95% CI 1.1-29.38, p = 0.038). Disease remained stable in all SSc patients during pregnancy and up to 1 year after delivery. Conclusions: We found an increased risk of APO in our SSc cohort in comparison with HC (with higher rates of miscarriages, preeclampsia, SGA newborns, and preterm deliveries) and SLE patients (presenting a higher rate of preterm deliveries). High-risk multidisciplinary management of SSc pregnant women is highly recommended.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/201562
url https://hdl.handle.net/2445/201562
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s13075-022-02783-0
Arthritis Research & Therapy, 2022, vol. 24, num. 1, p. 91
https://doi.org/10.1186/s13075-022-02783-0
dc.rights.none.fl_str_mv cc-by (c) Barilaro, Giuseppe et al., 2022
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Barilaro, Giuseppe et al., 2022
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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