Reproductive Challenges and Cardiovascular Risks in Sjögren’s Syndrome and Systemic Sclerosis: A Meta-Analysis of Fertility, Pregnancy Outcomes, and Maternal Cardiac Health

R. Mohamad Javier¹, Bernadus Bramantyo², Arkan Berlian³, Mahardika Nugraha⁴, Azzura Simanulang¹, Eko Setyo Herwanto⁵, Athaya Febriantyo Purnomo⁶, Jonathan Jonathan⁷, Ananingati Ananingati⁵, Budi Prakoso⁸ and Aisyah Rizki Nirmala Hanum⁵, ¹University of Indonesia Hospital, Jakarta Selatan, Jakarta Raya, Indonesia, ²Sardjito General Hospital, Daerah Istimewa Yogyakarta, Yogyakarta, Indonesia, ³Dr. Cipto Mangunkusumo Hospital, Jakarta Barat, Jakarta Raya, Indonesia, ⁴Universitas Islam Sultan Agung, KOTA SEMARANG, Jawa Tengah, Indonesia, ⁵Universitas Muhammadiyah Malang, Malang, Jawa Timur, Indonesia, ⁶Saiful Anwar General Hospita, Malang, Jawa Timur, Indonesia, ⁷RSUD Kalideres, Jakarta, Jakarta Raya, Indonesia, ⁸Department of Internal Medicine, RST dr Soepraoen, Malang, Jawa Timur, Indonesia

Meeting: ACR Convergence 2025

Keywords: Cardiovascular, pregnancy, Scleroderma, Systemic, Sjögren's syndrome

Session Information

Date: Monday, October 27, 2025

Title: (1376–1404) Sjögren’s Disease – Basic & Clinical Science Poster II: Clinical Manifestations and Health Outcomes

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Autoimmune rheumatic diseases such as Sjögren’s Syndrome (SS) and Systemic Sclerosis (SSc) can significantly impact reproductive health and increase maternal cardiovascular risk. These conditions are associated with fertility challenges, obstetric complications, and cardiac events during pregnancy, necessitating a thorough understanding for optimal maternal care. Evaluate reproductive outcomes and cardiac complications in women of reproductive age diagnosed with SS or SSc, including fertility status, pregnancy loss, preterm birth, cesarean delivery, and maternal cardiac morbidity.

Methods: A systematic search of PubMed, Embase, and Cochrane Library databases was conducted up to 2020. Eligible studies reported fertility and/or pregnancy outcomes in women with SS or SSc, with or without comparison to healthy controls. Data were pooled using a random-effects model, and heterogeneity was assessed using the I² statistic.

Results: A total of 32 studies comprising 4,820 women (SS: 2,140; SSc: 2,680) were included. Compared to controls, women with SS had a 1.8-fold increased risk of miscarriage (RR: 1.81, 95% CI: 1.42–2.30), while those with SSc showed a 2.4-fold increase in preterm delivery (RR: 2.43, 95% CI: 1.95–3.01). Fertility rates were modestly decreased in both groups (SS: −15%, SSc: −22%). Cardiac complications were significantly higher in SSc pregnancies, with elevated rates of arrhythmias (RR: 3.10, 95% CI: 2.05–4.70), preeclampsia (RR: 2.75), and heart failure events (RR: 2.12). Cesarean delivery was more common in both groups (SS: RR 1.48; SSc: RR 1.67).

Conclusion: Women with Sjögren’s Syndrome and Systemic Sclerosis are at increased risk of adverse reproductive and cardiac outcomes. These findings highlight the need for preconception risk assessment, specialized obstetric care, and interdisciplinary collaboration to improve maternal and fetal outcomes in this high-risk population.

PRISMA Flow Diagram

Forest Plot: Reproductive Outcome in SS and Systemic Sclerosis

Forest Plot: Preterm Delivery Risk

Disclosures: R. Javier: None; B. Bramantyo: None; A. Berlian: None; M. Nugraha: None; A. Simanulang: None; E. Herwanto: None; A. Purnomo: None; J. Jonathan: None; A. Ananingati: None; B. Prakoso: None; A. Hanum: None.

To cite this abstract in AMA style:

Javier R, Bramantyo B, Berlian A, Nugraha M, Simanulang A, Herwanto E, Purnomo A, Jonathan J, Ananingati A, Prakoso B, Hanum A. Reproductive Challenges and Cardiovascular Risks in Sjögren’s Syndrome and Systemic Sclerosis: A Meta-Analysis of Fertility, Pregnancy Outcomes, and Maternal Cardiac Health [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/reproductive-challenges-and-cardiovascular-risks-in-sjogrens-syndrome-and-systemic-sclerosis-a-meta-analysis-of-fertility-pregnancy-outcomes-and-maternal-cardiac-health/. Accessed .

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