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P81 15 years experience in follow-up of pregnancy of autoimmune diseases in a multidisciplinary unit
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  1. Esther Ruiz-Lucea1,
  2. Oihane Ibarguengoitia1,
  3. Natalia Rivera1,
  4. Jenaro Oraa3,
  5. Eduardo Úcar1,
  6. Ana Intxaurbe1,
  7. Itziar Calvo1,
  8. David Montero1,
  9. Lucia Vega1,
  10. Carmen García1,
  11. Clara Perez1,
  12. Olaia Fernández1,
  13. Ignacio Torre1,
  14. Juan Blanco1,
  15. Eva Galindez1,
  16. MJ Allande1,
  17. Iñigo Gorostiza2,
  18. Eduardo Cuende1 and
  19. Maria Luz García1
  1. 1Rheumatology Dept., Basurto University Hospital, Bilbao
  2. 2Research Unit, Basurto University Hospital, Bilbao
  3. 3Obstetric Dept., Basurto University Hospital, Bilbao, Spain

Abstract

Background Women with autoimmune diseases have high-risk pregnancies. Close and multidisciplinary control is recommended.

Objective To describe the experience in a multidisciplinary unit (Rheumatologists and Obstetrics), assess complications and treatments in the evolution of pregnancies in patients with autoimmune diseases in a tertiary hospital.

Material and Methods Retrospective study of pregnancy outcomes in patients with autoimmune diseases and follow-up in a multidisciplinary unit between January 2003-December 2018. Demographics, maternal disease, previous abortions, autoantibodies (AAb), births and abortions during follow-up, treatment and maternal and fetal complications were collected. Data analysed using SPSS v23.

Results 109 patients (151 pregnancies). Maternal age at diagnosis: 34,9 years; age at abortion/childbirth 38,6 years. 50 abortions registered prior to follow-up in our unit (0.45 abortions/mother). During follow-up 19 abortions were registered (0.17 abortions/mother) (table 1). Abortions were more frequent among women with positive antiphospholipid antibodies (aPL) (14.3% vs 4.3%) (p =0,013). Anti-Ro carriers (36.6%) didn’t have higher frequency of abortions (p =0,798); one case of heart block was recorded.

View this table:
Abstract P81 Table 1

13.5% pre-term (<37 weeks) pregnancies; caesarean section (C-section) performed in 26% (17,3% in SLE). Intrauterine growth restriction (IUGR) observed in 6 (3,9%); pre-eclampsia in 4 (2,6%): SLE (n:3 and n:2 respectively), APS (n:1 and n:1), anti-Ro carriers (n:2 and n:1). No difference in complications between anti-Ro positive and negative women (p =0.047).

Hydroxicloroquine prescribed in 97 patients (64%), aspirin in 99 (65,6%), heparin in 33 (21,9%) and prednisone in 48 (31%).

Conclusions In our series, women with SLE and APL have higher risk of abortion, pregnancy complications and instrumental delivery than general population. Anti-Ro carriers don’t have increased rate of abortions nor complications during pregnancy. Follow-up of pregnancy in a multidisciplinary unit decreases the risk of abortion.

https://doi.org/10.1136/lupus-2020-eurolupus.126

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