Increased risk of adverse gestational outcomes in pregnant women with primary Sjögren’s syndrome

• Published in: Rheumatic & musculoskeletal diseases open Vol. 10; no. 2; p. e003616
• Main Authors: Tan, Zhen, Shao, Meilin, Zhou, Yingbo, Wang, Li, Ma, Yan, Xiang, Nan, Yuan, Xiang, Wang, Bin, Xie, Xiangliang, Zhou, Mingtao, Wang, Yumin, Li, Sidong, Li, Xiaomei
• Format: Journal Article
• Language: English
• Published: England EULAR 28.05.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Abortion, Spontaneous - epidemiology; Abortion, Spontaneous - etiology; Adult; Antibodies; Anticoagulants; Autoimmune diseases; Autoimmunity; Birth weight; Case-Control Studies; China - epidemiology; Connective tissue; Disease; Electronic health records; Female; Fetuses; Gestational age; Heparin, Low-Molecular-Weight - therapeutic use; Hospitals; Humans; Hypertension; Infections; Medical records; Medical research; Miscarriage; Morphology; Placenta; Pregnancy; Pregnancy complications; Pregnancy Complications - epidemiology; Pregnancy Outcome; Premature birth; Retrospective Studies; Rheumatology; Risk Factors; Sjogren's Syndrome; Sjogren's Syndrome - complications; Sjogren's Syndrome - diagnosis; Sjogren's Syndrome - epidemiology; Sjögren Syndrome; Stillbirth; Womens health; China; Autoimmunity; Sjogren's Syndrome; Risk Factors
• ISSN: 2056-5933; 2056-5933
• DOI: 10.1136/rmdopen-2023-003616

ObjectivesThis study aimed to identify risk factors contributing to diverse pregnancy outcomes in primary Sjögren’s syndrome (pSS) cases.MethodsA retrospective analysis was conducted on pregnant individuals with pSS, who received outpatient or inpatient care across multiple hospitals in Anhui Province, China, from January 2015 to December 2022.ResultsThis study included 164 pregnant women with pSS and 328 control subjects, with no statistically significant difference in average age between the two groups. Analysis of pregnancy outcomes revealed that, compared with the control group, pregnant women in the pSS group were more likely to experience miscarriages, both spontaneous (12.80% vs 1.52%, p<0.001) and therapeutic (6.10% vs 0.91%, p<0.05). The proportion of placental abnormalities detected during prenatal ultrasound in women from the pSS group was higher (14.63% vs 6.40%, p<0.05). In the analysis of pregnancy outcomes for live-born neonates, a higher incidence of congenital heart abnormalities was observed in the pSS group (27.34% vs 12.03%, p<0.05). While there were no significant differences between the pSS pregnancies in terms of both normal and adverse pregnancy outcomes, a comparison of fetal survival and fetal loss in pSS pregnancies revealed a greater use of prophylactic anticoagulant therapy in the fetal survival group. Notably, the application of low molecular weight heparin (LMWH) emerged as an independent protective factor for fetal survival.ConclusionsCompared with non-autoimmune controls, pregnancy in women with pSS presents more challenges. Importantly, we observed that the use of LMWH as anticoagulant therapy is an independent protective measure for fetal survival.