Pregnancy outcomes in mixed connective tissue disease: a multicentre study.

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.

• Authors: Massimo Radin, Karen Schreiber, Maria José Cuadrado, Irene Cecchi, Laura Andreoli, Franco Franceschini, Teresa Caleiro, Danieli Andrade, Elena Gibbone, Munther Khamashta, Jill Buyon, Peter Izmirly, Maria Angeles Aguirre, Chiara Benedetto, Dario Roccatello, Luca Marozio, Savino Sciascia
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 58 Issue 11 Pg. 2000-2008 (11 01 2019) ISSN: 1462-0332 [Electronic] England
• PMID: 31079145 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Autoantibodies
• Ribonucleoprotein, U1 Small Nuclear

Topics

• Abortion, Spontaneous (epidemiology, immunology)
• Adult
• Autoantibodies (blood)
• Diabetes, Gestational (epidemiology, immunology)
• Female
• Fetal Growth Retardation (immunology)
• Heart Block (congenital, immunology)
• Humans
• Hypertension, Pregnancy-Induced (epidemiology, immunology)
• Infant, Newborn
• Live Birth (epidemiology)
• Lupus Erythematosus, Systemic (congenital, immunology)
• Mixed Connective Tissue Disease (complications, immunology)
• Pregnancy
• Pregnancy Complications (blood, immunology)
• Pregnancy Outcome
• Retrospective Studies
• Ribonucleoprotein, U1 Small Nuclear (immunology)
• Stillbirth (epidemiology)