Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: SLE pregnancies are complicated due to risk for maternal disease exacerbation and potential for fetal and neonatal complications. With careful pre-pregnancy counseling and monitoring during pregnancy, most women with SLE can anticipate a successful pregnancy. Less is known about pregnancy courses in women with other connective tissue diseases (oCTD). Our purpose was to co compare pregnancy outcomes in women with SLE with outcomes in women with oCTD and with other inflammatory rheumatic diseases.
Methods: The German pregnancy register Rhekiss is designed as nationwide, web-based longitudinal observational cohort study. Pregnant patients with confirmed diagnosis of inflammatory rheumatic disease are eligible to be enrolled until the 20th week of pregnancy. At baseline, sociodemographic parameters, disease severity, obstetric history, comorbidities and antibody status are reported. During each trimester, disease activity, flares, drug treatment and adverse pregnancy outcomes are documented. After birth, the outcome and child development during the first two years of life are collected
Results: Until April 2017, data from 455 patients were available (SLE [n=104]; other connective tissue diseases [oCTD, including UCTD, MCTD and Sjögren`s Syndrome, n=77] and patients with other inflammatory rheumatic diseases [oIRD, including rheumatoid arthritis (RA), juvenile RA, psoriatic arthritis, and spondyloarthritis, n=271]. 192 women had already completed their pregnancy. Approximately 80 % of all pregnancies were planned. At enrolment, disease activity (physicians’ global assessment, 0-10) was 1.6±1.5 [SLE] vs. 1.7±1.5 [oCTD] and 2.5±2.1 [oIRD]. HCQ was used in 63% [SLE] vs. 50% (oCTD) and 5% [oIRD]. Antiphospholipid-Syndrome was present in 14.2% [SLE] vs. 2.6% [oCTD] and 0.7 [oIRD]. The overall live birth rate was 93.7% [88.9% [SLE] vs 94.7% [oCTD] vs 95.4% [oIRD]]. Mean birth weight in singletons born at term was 3117 g [SLE] vs. 3131 g [oCTD] and 3477 g [oIRD]. Severe adverse pregnancy outcome included preterm birth [25% [SLE] vs 16.7% [oCTD] vs 16.3% [oIRD]] and preeclampsia [4.4% [SLE], 10.5% [oCTD], 0% [oIRD]]. Serious infections were documented in six preterm born newborns (all mothers had SLE or oCTD). Two neonatal deaths occurred (one in a baby born to a mother with SLE and APS who developed severe HELPP syndrome in her 23th week of pregnancy after inadvertent stopping of anticoagulation, the other death occurred in a preterm twin delivered in the 25th week of pregnancy by a mother with oCTD and triple aPl positivity.
Conclusion: Our real world data show that although most patients with SLE or oCTD have a successful outcome of pregnancy, compared to patients with oIRD, substantial more adverse pregnancy outcomes occurred in these women despite of a high rate of planned pregnancies. Prematurity is the main cause for serious complications.
Disclosures: Rhekiss is a collaborative project of the Rheumazentrum Rhein-Ruhr e.V. Düsseldorf and the DRFZ Berlin, jointly funded by both institutions.
To cite this abstract in AMA style:Fischer-Betz R, Bungartz C, Schneider M, Richter J, Weiss A, Zink A, Strangfeld A. Pregnancy Outcome in Patients with SLE Compared to Patients with Other Inflammatory Rheumatic Diseases: Real World Data from a Prospective Pregnancy Register [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/pregnancy-outcome-in-patients-with-sle-compared-to-patients-with-other-inflammatory-rheumatic-diseases-real-world-data-from-a-prospective-pregnancy-register/. Accessed April 9, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/pregnancy-outcome-in-patients-with-sle-compared-to-patients-with-other-inflammatory-rheumatic-diseases-real-world-data-from-a-prospective-pregnancy-register/