The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Pregnancy Outcome in Early Rheumatic Disease

Pregnancy Outcome in Early Rheumatic Disease

September 28, 2016 • By Arthritis & Rheumatology

  • Tweet
  • Email
Print-Friendly Version / Save PDF

Systemic autoimmune rheumatic diseases are associated with increased rates of adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, fetal growth restriction (FGR) and prematurity. Although retrospective epidemiologic data suggest that adverse pregnancy outcomes often antedate the subsequent development of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc) or antiphospholipid syndrome (APS), the effect of preclinical autoimmune systemic diseases on pregnancy outcome has not been well studied. In a previous cohort study, using a two-step approach with a self-reported questionnaire and autoantibody detection, these authors evaluated the effects of well-defined rheumatic diseases diagnosed during the first trimester on pregnancy outcome. The purpose of the present study, carried out using a similar approach, was to evaluate the effects of preclinical or incomplete autoimmune systemic rheumatic disorders detected during the first trimester of pregnancy on pregnancy outcome.

You Might Also Like
  • Promote Pregnancy Wellness: Data Can Help Guide Pregnancy Management in Lupus
  • Rheumatic Disease Does Not Preclude Pregnancy
  • Carpal Tunnel Syndrome of Pregnancy May Persist Long After Delivery

Methods. In this longitudinal cohort study, patients were enrolled during the first trimester of pregnancy if they reported having had connective tissue disorder symptoms, were found to be positive for circulating autoantibodies and, on clinical evaluation, were judged to have a preclinical or incomplete rheumatic disorder. The incidence of fetal growth restriction (FGR), preeclampsia and adverse pregnancy outcomes in patients with preclinical rheumatic disorders was compared with that in selected controls, after adjustment for confounders by penalized logistic regression.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Results. Of 5,232 women screened, 150 (2.9%) were initially diagnosed as having a suspected rheumatic disorder. After a mean ± SD postpartum follow-up of 16.7 ± 5.5 months, 64 of these women (42.7%) had no clinically apparent rheumatic disease and 86 (57.3%) had persistent symptoms and positive autoantibody results, including 10 (6.7%) who developed a definitive rheumatic disease. The incidences of preeclampsia/FGR and of small-for-gestational-age infants were 5.1% (23 of 450) and 9.3% (42 of 450), respectively, among controls, 12.5% (8 of 640) (OR 2.7 [95% CI 1.1–6.4]) and 18.7% (12 of 64) (OR 2.2 [95% CI 1.1–4.5]), respectively, among women with no clinically apparent disease, and 16.3% (14 of 86) (OR 3.8 [95%CI 1.9–7.7]) and 18.6% (16 of 86) (OR 2.3 [95% CI 1.2– 4.3]), respectively, among those with persisting symptoms at follow-up. Mean ± SD umbilical artery Doppler pulsatility indices were higher among women with no clinically apparent disease (0.95 ± 0.2) and those with persisting symptoms (0.96 ± 0.21) than in controls (0.89 ± 0.12) (P = 0.01 and P < 0.001, respectively).

Conclusion. The evidence from this study suggest that in pregnant women with mild preclinical or incomplete rheumatic disease detected during the first trimester of pregnancy is associated with an increased risk of preeclampsia and FGR, SGA or other adverse pregnancy outcomes. Even positive autoantibody status during the first trimester with no clinically apparent rheumatic disease at postpartum follow-up is associated with an increased risk of fetal growth failure.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

The impact of these findings and their utility in screening for FGR and preeclampsia need to be confirmed in population studies.

Read the full article.

Excerpted and adapted from:
Spinillo A, Beneventi F, Locatelli E, et al. Early, Incomplete, or preclinical autoimmune systemic rheumatic diseases and pregnancy outcome. Arthritis Rheumatol. 2016 Oct;68(10):2555–2562.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 | Multi-Page

Filed Under: Conditions Tagged With: Arthritis & Rheumatology, pregnancy, rheumatic

You Might Also Like:
  • Promote Pregnancy Wellness: Data Can Help Guide Pregnancy Management in Lupus
  • Rheumatic Disease Does Not Preclude Pregnancy
  • Carpal Tunnel Syndrome of Pregnancy May Persist Long After Delivery
  • New Study Examines Pregnancy Risk Factors for Patients with Lupus

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.