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Poor maternal and foetal outcomes in women with systemic sclerosis: an interview-based study at a tertiary centre

  • Observational Research
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Abstract

Poor obstetric outcomes are described in rheumatic diseases (RDs) such as systemic sclerosis (SSc). We assessed the effect of the disease in Indian women and compared with those in developed countries and other RDs. Women with SSc (ACR/EULAR 2013 criteria) registered at a tertiary care centre (2010–2016) were interviewed by teleconsultation. Pregnancies occurring after disease onset were compared with those occurring prior to it. Maternal complications included antepartum hemorrhage, postpartum hemorrhage, spontaneous abortion, preterm rupture of membrane, oligohydramnios, infection, prolonged labour, and foetal complications including low birth weight (LBW), intrauterine death (IUD), preterm delivery, and neonatal infection. Results were expressed as median (Interquartile range). Of 200 SSc, 75 patients aged 31 (22–38) years and disease duration 41 (32–50) months were interviewed. Diffuse cutaneous SSc was the most common (42.56%). 127 conceptions before the onset of SSc were compared with 15 after. Among post-diagnosis, 9 (60%) were live births, 3 (20%) spontaneous abortions 1 (6.7%) induced abortion, 2 (13.3%) IUD. Of the live births, 4 (26.7%) were preterm and 3 (20%) were LBW. Pregnancies after disease onset had a higher rate of maternal (OR − 4.9) and foetal (OR − 9.9) complications compared to pregnancies before SSc. Compared to the Italian cohort, Indian SSc patients had a higher abortion rate (OR − 5.8), frequent lower section ceaserean section (OR − 9.4) and lower live births (OR − 0.05). More frequent caesarean deliveries (OR − 93), preterm deliveries (OR − 20) when compared with lupus and favourable maternal outcomes (OR − 0.15), higher preterm deliveries (OR − 9.6) in comparison with Takayasu arteritis were noted. SSc incurs a higher risk of poor maternal as well as the foetal outcome.

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Abbreviations

RD:

Rheumatic disease

SSc:

Systemic sclerosis

LBW:

Low birth weight

IUD:

Intrauterine death

OR:

Odds ratio

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Authors and Affiliations

  1. Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India

    Rajat Kharbanda, R. Naveen, Durga Prasanna Misra, Latika Gupta & Vikas Agarwal

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  1. Rajat Kharbanda
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  2. R. Naveen
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  3. Durga Prasanna Misra
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  4. Latika Gupta
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Contributions

Ideation: RK, LG, VA; Data extraction: RK, RN, LG; Data analysis: RK, RN, DPM; Preparing the first draft: RK, RN, LG revising the manuscript for critical intellectual inputs: RK, RN, LG, DPM, VA. All authors agree with the submitted version of the manuscript, take responsibility for the content of the entire manuscript, and affirm that any queries related to any aspect of the same are appropriately managed.

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Correspondence to Latika Gupta.

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Kharbanda, R., Naveen, R., Misra, D.P. et al. Poor maternal and foetal outcomes in women with systemic sclerosis: an interview-based study at a tertiary centre. Rheumatol Int 41, 1133–1142 (2021). https://doi.org/10.1007/s00296-021-04793-8

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