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- Title
Pregnancy outcomes in mixed connective tissue disease: a multicentre study.
- Authors
Radin, Massimo; Schreiber, Karen; Cuadrado, Maria José; Cecchi, Irene; Andreoli, Laura; Franceschini, Franco; Caleiro, Teresa; Andrade, Danieli; Gibbone, Elena; Khamashta, Munther; Buyon, Jill; Izmirly, Peter; Aguirre, Maria Angeles; Benedetto, Chiara; Roccatello, Dario; Marozio, Luca; Sciascia, Savino
- Abstract
Objectives In this study we aimed to investigate foetal and maternal pregnancy outcomes from a large multicentre cohort of women diagnosed with MCTD and anti-U1RNP antibodies. Methods This multicentre retrospective cohort study describes the outcomes of 203 pregnancies in 94 consecutive women ever pregnant who fulfilled the established criteria for MCTD with confirmed U1RNP positivity. Results The foetal outcomes in 203 pregnancies were as follows: 146 (71.9%) live births, 38 (18.7%) miscarriages (first trimester pregnancy loss of <12 weeks gestation), 18 (8.9%) stillbirths (pregnancy loss after 20 weeks gestation) and 11 (5.4%) cases with intrauterine growth restriction. Maternal pregnancy outcomes were as follows: 8 (3.9%) developed pre-eclampsia, 2 (0.9%) developed eclampsia, 31 (15.3%) developed gestational hypertension and 3 (1.5%) developed gestational diabetes. Women with MCTD and aPL and pulmonary or muscular involvement had worse foetal outcomes compared with those without. Moreover, we report a case of complete congenital heart block (0.45%) and a case of cutaneous neonatal lupus, both born to a mother with positive isolated anti-U1RNP and negative anti-Ro/SSA antibodies. Conclusion In our multicentre cohort, women with MCTD had a live birth rate of 72%. While the true frequency of heart block associated with anti-U1RNP remains to be determined, this study might raise the consideration of echocardiographic surveillance in this setting. Pregnancy counselling should be considered in women with MCTD.
- Subjects
HYPERTENSION in pregnancy; RISK factors of preeclampsia; ECLAMPSIA; PREGNANCY complication risk factors; RISK factors in miscarriages; PERINATAL death; HEART block; GESTATIONAL diabetes; AUTOANTIBODIES; CHILDBIRTH; CONGENITAL heart disease; CONNECTIVE tissue diseases; ECHOCARDIOGRAPHY; LONGITUDINAL method; EVALUATION of medical care; MEDICAL cooperation; PREGNANCY; FIRST trimester of pregnancy; PREGNANT women; PRENATAL diagnosis; RESEARCH; RISK assessment; SYSTEMATIC reviews; RETROSPECTIVE studies; DISEASE complications; DISEASE risk factors
- Publication
Rheumatology, 2019, Vol 58, Issue 11, p2000
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kez141