ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2184

Pregnancy and Fetal Outcome in Patients with an Established Diagnosis of Primary Sjögren’s Syndrome.

Roberta Priori1, Angelica Gattamelata2, Mariagrazia Modesti3, Serena Colafrancesco3, Marta Maset4, Luca Quartuccio4, Salvatore De Vita5, Elena Bartoloni Bocci6, Alessia Alunno7, Roberto Gerli6, Francesca Strigini8, Chiara Baldini9, Chiari Tani9, Marta Mosca9, Stefano Bombardieri9 and Guido Valesini3, 1Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy, 2Sapienza University of Rome, Rome, Italy, 3Rheumatology Unit, Sapienza University of Rome, Rome, Italy, 4Rheumatology Clinic, DSMB, University of Udine, Udine, Italy, 5Rheumatology, DSMB, University Hospital Santa Maria della Misericordia, Udine, Italy, 6Rheumatology Unit, Department of Clinical & Experimental Medicine, University of Perugia, Perugia, Italy, 7Clinical and Experimental Medicine, Rheumatology Unit, University of Perugia, Perugia, Italy, 8Internal Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy, 9Rheumatology Unit, University of Pisa, Pisa, Italy

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Sjögren's Syndrome - Clinical

Session Type: Abstract Submissions (ACR)

Background/Purpose:

To investigate pregnancy and fetal outcome in patients with an established diagnosis of primary Sjögren’s syndrome (pSS) 

Methods:

The clinical charts of 1075 women with pSS, from four Italian referral rheumatology centres were retrospectively evaluated. When a pregnancy has occurred after pSS diagnosis, the patient was personally interviewed to obtain more detailed information regarding obstetric history; obstetric clinical charts were reviewed as well. In a subgroup analysis from a single center, each delivery in patients with an established diagnosis of pSS was compared with the first 8 consecutive deliveries occurred during the same month in the referral universitary hospital. Chi square and Mann-Whitney test, SPSS release 15.00, were used for statistical analysis.

Results:

Patients’ mean age was 59 yr (17-89), mean age at diagnosis 51,4 yr; 139/1075 (12,8%) were diagnosed before 35 yr. Thirty-six women (31 with anti-SSA/Ro and/or anti-SSA/La antibodies) with an established diagnosis of pSS had 45 pregnancies which ended with the delivery of 40 newborns. Two miscarriages, 2 fetal death and one induced abortion were recorded. Mean age at the first pregnancy was 33,9 yr (range 27-44), mean number of pregnancy 1,25 (1-3); 18/40 (45%) cesarean sections were performed, mean pregnancy length was 38,5 week (range 32-43) with 6 preterm delivery. The mean Apgar score at 5 minute was 8,9 (range 5-10), mean birth weight was 2920 mg (range 826-4060). Congenital heart block (CHB) occurred in 2/36 newborns (5,5%) of 31 mothers with anti-SSA and/or SSB antibodies with fatal outcome. The reported rate of breastfeeding for at least one month was 60,5% (range 1-21 months), 44,7% for 3 months, During pregnancy one patient presented thrombocytopenia and another palpable purpura. In 4/40 pregnancies (10%) a flare of disease activity was observed within a year from delivery. In the case-control subgroup analysis no significant differences were found regarding age at delivery, pregnancy duration, way of delivery, baby sex. The neonates of primary SS mothers tended to have a lower weight and a lower Apgar score but the difference was not significant. 

Conclusion:

Even if pSS generally starts after menopause, it can appear during the childbearing age. pSS can have successful pregnancies, which might be followed by a mild relapse. CHB, a fearful complication for women with anti-SSA/Ro and or anti-SSB/La antibodies, is the only cause of death for offspring of pSS mothers.

Disclosure:

R. Priori,
None;

A. Gattamelata,
None;

M. Modesti,
None;

S. Colafrancesco,
None;

M. Maset,
None;

L. Quartuccio,
None;

S. De Vita,
None;

E. Bartoloni Bocci,
None;

A. Alunno,
None;

R. Gerli,
None;

F. Strigini,
None;

C. Baldini,
None;

C. Tani,
None;

M. Mosca,
None;

S. Bombardieri,
None;

G. Valesini,
None.

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