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AB1195 PREGNANCIES IN AUTOIMMNUNE DISEASES: EXPERIENCE OF TWO CENTERS IN CALI, COLOMBIA: 2011- 2018
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  1. álvaro Arbeláez-Cortés1,2,3,4,
  2. Maria Andrea Moreno Salamanca4,
  3. Diana Carolina Quintero González3
  1. 1Clínica de Artritis Temprana, Cali, Colombia
  2. 2Centro Médico Imbanaco de Cali S.A., Cali, Colombia
  3. 3Universidad Libre de Cali, Internal Medicine, Cali, Colombia
  4. 4Universidad Libre de Cali, Cali, Colombia

Abstract

Background The outcome in pregnancy varies according to the rheumatic disease.

Objectives To describe the pregnancies outcomes of women with rheumatic diseases at two reference centers in Cali, Colombia.

Methods Descriptive study. Records of pregnant patients attended from August 2011 to December 2018 were reviewed. Thirty-nine patients were found, 11 without a defined rheumatic entity (10 with positive ANA only, and 1 with incomplete criteria for antiphospholipid syndrome), and 28 with an autoimmune rheumatic disease. A total of 41 pregnancies occurred (2 women with 2 pregnancies) and were chosen for the final analysis (Table).

Results The mean gestational age at the first rheumatology visit was 16,8 ± 8,9. The mean age at the end of pregnancy was 29,5 ± 5,7 years. Only nine pregnancies were planned (34,6%). Among the patients with a defined autoimmune disease the diagnoses were: systemic lupus erythematosus (SLE) (12), rheumatoid arthritis (RA) (5), antiphospholipid syndrome (APS) (2), autoimmune hemolytic anemia (AHA) (2), juvenile idiopathic arthritis (JIA) (2), overlap syndrome (OS) (3: 2 SLE/SSc; 1 SLE/Sjögren’s) mixed connective tissue disease (MCTD) (1) and undifferentiated connective tissue disease (UCTD) (1). There were 8 pregnancies exposed to teratogenic drugs (MTX 5, LEF 1, MMF 1, CYC 1): 2 ended in fetal loss and 1 had a congenital pneumonia. There were 27 full-term births, 37-40 weeks (wk); 8 preterm births, 23-36 wk (4 twins); 1 stillbirth, 26 wk; and 3 abortions (2 in the same mother). Seven patients had an active disease before pregnancy, 13 during pregnancy (7 SLE, 3 RA, 2 AIHA, 1 MCTD) and 13 during the puerperium (7 SLE, 4 AR, 1 AIJ, 1 EMTC). No maternal deaths, neonatal lupus or congenital heart block were documented in this series. Four patients did not require any medication. One woman received treatment for pulmonary tuberculosis, and other was on anti-retroviral treatment for HIV infection. At the last follow-up, 2 patients were still pregnant.

Conclusion The outcome of rheumatic disease during pregnancy remains variable. It seems that SLE patients tend to be more active and flare more commonly than other patients. The documented complications were similar to those reported in the literature.

References [1] Davutoğlu EA, Ozel A, Yılmaz N, Madazli R. Pregnancy outcome in 162 women with rheumatic diseases: experience of a university hospital in Turkey. Arch Gynecol Obstet. 2017 Dec;296(6):1079-1084.

Table. Main clinical findings and outcomes

Disclosure of Interests None declared

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