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Rigshospitalet - a part of Copenhagen University Hospital

A multicentre study of 244 pregnancies in undifferentiated connective tissue disease: maternal/fetal outcomes and disease evolution

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  • Massimo Radin
  • Karen Schreiber
  • Irene Cecchi
  • Alessandra Bortoluzzi
  • Francesca Crisafulli
  • Cristiano M de Freitas
  • Beatrice Bacco
  • Elena Rubini
  • Silvia G Foddai
  • Melissa Padovan
  • Silvia Gallo Cassarino
  • Franco Franceschini
  • Danieli Andrade
  • Chiara Benedetto
  • Marcello Govoni
  • Tiziana Bertero
  • Luca Marozio
  • Dario Roccatello
  • Laura Andreoli
  • Savino Sciascia
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OBJECTIVES: To investigate fetal/perinatal and maternal outcomes from a large multicentre cohort of women diagnosed with UCTD.

METHODS: This multicentre retrospective cohort study describes the outcomes of 224 pregnancies in 133 consecutive women with a diagnosis of UCTD, positive for ANA and aged <45 years old at study inclusion.

RESULTS: Of the 224 pregnancies analysed, 177 (79%) resulted in live births, 45 (20.1%) in miscarriages (defined as pregnancy loss before 12 weeks' gestation), 2 (0.9%) in stillbirths (pregnancy loss after 20 weeks' gestation) and 6 (2.7%) cases showed intrauterine growth restriction. Miscarriages and stillbirths were strongly associated with the presence of aPL and ENA antibodies (P < 0.05). Maternal pregnancy complications were as follows: 5 (2.2%) cases developed pre-eclampsia, 11 (4.9%) cases gestational hypertension and 12 (5.4%) cases gestational diabetes. Joint involvement represented the most frequent clinical manifestation of the cohort (57.9%), followed by RP (40.6%), photosensitivity (32.3%) and haematological manifestations (27.1%). The rate of disease evolution of our cohort from a diagnosis of UCTD to a diagnosis of definite CTD was 12% within a mean time of 5.3 ± 2.8 years. With a total follow-up after first pregnancy of 1417 patient-years, we observed the evolution to a defined CTD in one out of every 88 patient- years.

CONCLUSION: In our multicentre cohort, women with UCTD had a live birth rate of 79%. Women with UCTD should be referred to specialist follow-up when planning a pregnancy. ENA profiling and aPL testing should be mandatory in this setting, and further therapeutic approaches and management should be planned accordingly.

Original languageEnglish
JournalRheumatology (Oxford, England)
Issue number9
Pages (from-to)2412-2418
Number of pages7
Publication statusPublished - 1 Sep 2020

    Research areas

  • Abortion, Spontaneous/epidemiology, Adult, Antibodies, Antinuclear/blood, Antibodies, Antiphospholipid/blood, Autoantibodies/blood, Female, Fetal Growth Retardation/epidemiology, Humans, Live Birth/epidemiology, Pregnancy, Pregnancy Complications/blood, Pregnancy Outcome/epidemiology, Retrospective Studies, Stillbirth/epidemiology, Undifferentiated Connective Tissue Diseases/blood, anti-nuclear antibodies, pregnancy, undifferentiated connective tissue disease, autoimmune disease, neonatal lupus, congenital heart block, pregnancy complications, autoantibodies

ID: 61876054