Pregnancy outcomes in connective tissue diseases: a 30-year study of 465 cases from a single-center Spanish registry with insights on hydroxychloroquine use.
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| Title: | Pregnancy outcomes in connective tissue diseases: a 30-year study of 465 cases from a single-center Spanish registry with insights on hydroxychloroquine use. |
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| Authors: | Sieiro Santos C.1 cristysieirosantos@gmail.com, Ordas Martínez J.1, Moriano Morales C.1, Álvarez Castro C.1, Díez Álvarez E.1 |
| Source: | ARP Rheumatology. Jan-Mar2025, Vol. 4 Issue 1, p29-36. 8p. |
| Subjects: | PREGNANCY outcomes, MISCARRIAGE, SJOGREN'S syndrome, CONNECTIVE tissue diseases, DISEASE risk factors, TEENAGE pregnancy |
| Abstract: | Introduction: Pregnancy in women with connective tissue diseases (CTDs), including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), primary Sjögren's syndrome (pSS), and undifferentiated connective tissue disease (UCTD), poses significant risks for adverse outcomes. Evaluating these risks and outcomes is essential to improve maternal and fetal health. Objectives: This study aimed to assess pregnancy outcomes in patients with CTDs, identify factors associated with adverse outcomes, and evaluate the protective effects of hydroxychloroquine (HCQ) treatment. Methods: A study covering the period from 1990 to 2022 was conducted. Data were collected from medical records of childbearing-age women with SLE, SSc, pSS, and UCTD who were under care at our clinic. Obstetric, maternal, and fetal outcomes were analyzed across different diagnoses. Statistical analyses were performed to identify associations between disease activity, treatments, and pregnancy outcomes. Results: A total of 295 patients (125 with SLE, 50 with SSc, 80 with pSS, and 40 with UCTD) and 465 pregnancies were included. The mean age at first pregnancy was 29.1±9.1 years. Pregnancy loss occurred in 21% of cases, while 77% resulted in live births. Adverse outcomes included preterm delivery (8%), postpartum hemorrhage (6%), and preeclampsia (5%). SLE diagnosis (OR 1.5, 95% CI [1.1-4.8], p = 0.03), double/triple antiphospholipid antibody (APL) positivity (OR 2.3, 95% CI [1.1-3.9], p = 0.04), and active disease (OR 3.4, 95% CI [1.8-5.2], p = 0.004) were identified as risk factors for adverse pregnancy outcomes. HCQ treatment demonstrated a protective effect (OR 0.34, 95% CI [0.05-0.72], p = 0.0004). Conclusion: Two-thirds of pregnancies in women with CTDs resulted in live births, though SLE was associated with significantly higher risks. Active disease during pregnancy emerged as a major risk factor. Importantly, the use of HCQ was associated with a notable reduction in these risks, underscoring its protective role in improving pregnancy outcomes. These findings highlight the critical importance of preconception counseling, careful disease management, and the proactive use of HCQ to minimize complications and optimize outcomes in pregnancies complicated by CTDs. [ABSTRACT FROM AUTHOR] |
| Copyright of ARP Rheumatology is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: lth DbLabel: MedicLatina An: 184410540 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Pregnancy outcomes in connective tissue diseases: a 30-year study of 465 cases from a single-center Spanish registry with insights on hydroxychloroquine use. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Sieiro+Santos+C%2E%22">Sieiro Santos C.</searchLink><relatesTo>1</relatesTo><i> cristysieirosantos@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Ordas+Martínez+J%2E%22">Ordas Martínez J.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Moriano+Morales+C%2E%22">Moriano Morales C.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Álvarez+Castro+C%2E%22">Álvarez Castro C.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Díez+Álvarez+E%2E%22">Díez Álvarez E.</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22ARP+Rheumatology%22">ARP Rheumatology</searchLink>. Jan-Mar2025, Vol. 4 Issue 1, p29-36. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22PREGNANCY+outcomes%22">PREGNANCY outcomes</searchLink><br /><searchLink fieldCode="DE" term="%22MISCARRIAGE%22">MISCARRIAGE</searchLink><br /><searchLink fieldCode="DE" term="%22SJOGREN'S+syndrome%22">SJOGREN'S syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22CONNECTIVE+tissue+diseases%22">CONNECTIVE tissue diseases</searchLink><br /><searchLink fieldCode="DE" term="%22DISEASE+risk+factors%22">DISEASE risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22TEENAGE+pregnancy%22">TEENAGE pregnancy</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Introduction: Pregnancy in women with connective tissue diseases (CTDs), including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), primary Sjögren's syndrome (pSS), and undifferentiated connective tissue disease (UCTD), poses significant risks for adverse outcomes. Evaluating these risks and outcomes is essential to improve maternal and fetal health. Objectives: This study aimed to assess pregnancy outcomes in patients with CTDs, identify factors associated with adverse outcomes, and evaluate the protective effects of hydroxychloroquine (HCQ) treatment. Methods: A study covering the period from 1990 to 2022 was conducted. Data were collected from medical records of childbearing-age women with SLE, SSc, pSS, and UCTD who were under care at our clinic. Obstetric, maternal, and fetal outcomes were analyzed across different diagnoses. Statistical analyses were performed to identify associations between disease activity, treatments, and pregnancy outcomes. Results: A total of 295 patients (125 with SLE, 50 with SSc, 80 with pSS, and 40 with UCTD) and 465 pregnancies were included. The mean age at first pregnancy was 29.1±9.1 years. Pregnancy loss occurred in 21% of cases, while 77% resulted in live births. Adverse outcomes included preterm delivery (8%), postpartum hemorrhage (6%), and preeclampsia (5%). SLE diagnosis (OR 1.5, 95% CI [1.1-4.8], p = 0.03), double/triple antiphospholipid antibody (APL) positivity (OR 2.3, 95% CI [1.1-3.9], p = 0.04), and active disease (OR 3.4, 95% CI [1.8-5.2], p = 0.004) were identified as risk factors for adverse pregnancy outcomes. HCQ treatment demonstrated a protective effect (OR 0.34, 95% CI [0.05-0.72], p = 0.0004). Conclusion: Two-thirds of pregnancies in women with CTDs resulted in live births, though SLE was associated with significantly higher risks. Active disease during pregnancy emerged as a major risk factor. Importantly, the use of HCQ was associated with a notable reduction in these risks, underscoring its protective role in improving pregnancy outcomes. These findings highlight the critical importance of preconception counseling, careful disease management, and the proactive use of HCQ to minimize complications and optimize outcomes in pregnancies complicated by CTDs. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of ARP Rheumatology is the property of Sociedade Portuguesa de Reumatologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.63032/SEDD2624 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 29 Subjects: – SubjectFull: PREGNANCY outcomes Type: general – SubjectFull: MISCARRIAGE Type: general – SubjectFull: SJOGREN'S syndrome Type: general – SubjectFull: CONNECTIVE tissue diseases Type: general – SubjectFull: DISEASE risk factors Type: general – SubjectFull: TEENAGE pregnancy Type: general Titles: – TitleFull: Pregnancy outcomes in connective tissue diseases: a 30-year study of 465 cases from a single-center Spanish registry with insights on hydroxychloroquine use. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Sieiro Santos C. – PersonEntity: Name: NameFull: Ordas Martínez J. – PersonEntity: Name: NameFull: Moriano Morales C. – PersonEntity: Name: NameFull: Álvarez Castro C. – PersonEntity: Name: NameFull: Díez Álvarez E. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: Jan-Mar2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 27954552 Numbering: – Type: volume Value: 4 – Type: issue Value: 1 Titles: – TitleFull: ARP Rheumatology Type: main |
| ResultId | 1 |
