Objectives To investigate pregnancy and fetal outcome in patients with an established diagnosis of primary Sjögren’s syndrome (pSS)
Methods The clinical charts of 1073 women with pSS from four rheumatology centres were retrospectively evaluated. When a pregnancy has occurred after pSS diagnosis, the patient was personally interviewed to obtain more detailed information regarding obstetric history; obstetric clinical charts were reviewed as well.
Results Patients’ mean age was 59 yr (17-89), mean age at diagnosis 51,4 yr; 138/1073 (12,8%) were diagnosed before 35 yr. Thirty-five women (31 with anti-SSA/Ro and/or anti-SSA/La antibodies) with an established diagnosis of pSS had 44 pregnancies which ended with the delivery of 39 newborns. Two miscarriages, 2 fetal death and one induced abortion were recorded. Mean age at the latest pregnancy was 34,6 yr (range 29-44), mean number of pregnancy 1,25 (1-3); 17/39 cesarean sections were performed, mean pregnancy length was 38,5 week (range 32-43) with 6 preterm delivery. The mean Apgar score at 5 minute was 8,9 (range 5-10), mean birth weight was 2934 mg (range 826-4060). Congenital heart block (CHB) occurred in 2 newborns of 31 mothers with anti-SSA and/or SSB antibodies (6,45%), with fatal outcome. Other 2 infants had cardial incontinence and a mild interatrial defect, respectively. During pregnancy one patient presented thrombocytopenia and another palpable purpura. In 4/39 pregnancies (10,2%) a flare of disease activity was observed (arthralgia/arthritis and central nervous system involvement) within a year from delivery.
Conclusions Even if pSS generally starts after menopause, it can appear during the childbearing age. pSS can have successful pregnancies, which might be followed by a mild relapse. CHB is a fearful complication for women with anti-SSA/Ro and or anti-SSB/La antibodies.
Disclosure of Interest None Declared