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.
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.
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