Outcome of pregnancies complicated by systemic sclerosis and mixed connective tissue disease

Systemic sclerosis (SSc) and mixed connective tissue disease (MCTD) are rare autoimmune diseases which share the common feature of non-inflammatory vasculopathy. Studies evaluating pregnancy outcomes in these patients have yielded conflicting results. We sought to describe the outcomes of pregnancie...

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Bibliographic Details
Published in:	Lupus Vol. 15; no. 9; pp. 595 - 599
Main Authors:	Chung, L, Flyckt, R LR, Colón, I, Shah, A A, Druzin, M, Chakravarty, E F
Format:	Journal Article
Language:	English
Published:	Thousand Oaks, CA SAGE Publications 01-01-2006 Sage Publications Ltd
Subjects:	Adult Antibodies Antiphospholipid Syndrome - epidemiology Blood pressure California - epidemiology Cesarean Section Connective tissue diseases Female Fetal Death - epidemiology Fetal Death - etiology Follow-Up Studies Gestational Age Humans Immunology Lupus Medicine Miscarriage Mixed Connective Tissue Disease - complications Mixed Connective Tissue Disease - epidemiology Obstetric Labor, Premature - epidemiology Obstetric Labor, Premature - etiology Obstetrics Patients Pre-Eclampsia - epidemiology Pre-Eclampsia - etiology Preeclampsia Pregnancy Pregnancy Complications - epidemiology Pregnancy Outcome Raynaud disease Retrospective Studies Rheumatic diseases Rheumatology Scleroderma Scleroderma, Systemic - complications Scleroderma, Systemic - epidemiology Severity of Illness Index Womens health California United States > US systemic sclerosis mixed connective tissue disease outcomes pregnancy
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Summary:	Systemic sclerosis (SSc) and mixed connective tissue disease (MCTD) are rare autoimmune diseases which share the common feature of non-inflammatory vasculopathy. Studies evaluating pregnancy outcomes in these patients have yielded conflicting results. We sought to describe the outcomes of pregnancies associated with SSc and MCTD followed at our center utilizing a retrospective review of all pregnant women with SSc and MCTD followed at Stanford University from 1993 to 2003. We identified 20 pregnancies occurring in 13 women with SSc or MCTD. Twelve pregnancies occurred in seven women with SSc and eight pregnancies occurred in six women with MCTD. The overall preterm delivery rate was 39% and small for gestational age infants occurred in 50% and 63% of pregnancies associated with SSc and MCTD, respectively. Fetal loss complicated two pregnancies in women with severe diffuse SSc and the antiphospholipid antibody syndrome. There were no cases of congenital heartblock among infants, and only one case of pre-eclampsia was observed. Maternal flares of disease during pregnancy were generally mild. Most pregnancies in women with SSc and MCTD in this cohort were uncomplicated. The high rates of prematurity and small for gestational age infants underscore the risk for growth restriction consistent with the vasculopathy associated with these diseases.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0961-2033 1477-0962
DOI:	10.1177/0961203306071915