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

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art_RADIN_A_multicentre_study_of_244_pregnancies_in_undifferentiated_2020.PDF.pdf (339.72 KB)
Citações na Scopus
22
Tipo de produção
article
Data de publicação
2020
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Autores
RADIN, Massimo
SCHREIBER, Karen
CECCHI, Irene
BORTOLUZZI, Alessandra
CRISAFULLI, Francesca
FREITAS, Cristiano M. de
BACCO, Beatrice
RUBINI, Elena
FODDAI, Silvia G.
PADOVAN, Melissa
Citação
RHEUMATOLOGY, v.59, n.9, p.2412-2418, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
Palavras-chave
undifferentiated connective tissue disease, anti-nuclear antibodies, pregnancy, pregnancy complications, autoimmune disease, congenital heart block, neonatal lupus, autoantibodies
URI
https://observatorio.fm.usp.br/handle/OPI/38559
Referências
  1. Aggarwal R, 2015, ARTHRIT CARE RES, V67, P891, DOI 10.1002/acr.22583
  2. ALARCON GS, 1991, J RHEUMATOL, V18, P1332
  3. Andreoli L, 2017, ANN RHEUM DIS, V76, P476, DOI 10.1136/annrheumdis-2016-209770
  4. [Anonymous], 2017, BMC PREGNANCY CHILDB, V17, P437
  5. Antunes M, 2018, RMD OPEN, V4, DOI 10.1136/rmdopen-2018-000786
  6. Bourn R, 2015, CURR OPIN RHEUMATOL, V27, P433, DOI 10.1097/BOR.0000000000000199
  7. Brito-Zeron P, 2015, NAT REV RHEUMATOL, V11, P301, DOI 10.1038/nrrheum.2015.29
  8. Castellino G, 2011, LUPUS, V20, P1305, DOI 10.1177/0961203311409610
  9. D'Agostino RB, 2008, CIRCULATION, V117, P743, DOI 10.1161/CIRCULATIONAHA.107.699579
  10. Doria A, 2005, J RHEUMATOL, V32, P213
  11. Elfving P, 2016, RHEUMATOL INT, V36, P917, DOI 10.1007/s00296-016-3474-7
  12. Fredi M, 2019, FRONT CARDIOVASC MED, V6, DOI 10.3389/fcvm.2019.00011
  13. Garcia-Gonzalez M, 2017, CLIN EXP RHEUMATOL, V35, P739
  14. Goldenberg RL, 2008, LANCET, V371, P75, DOI 10.1016/S0140-6736(08)60074-4
  15. Grava C, 2005, REUMATISMO, V57, P180, DOI 10.4081/reumatismo.2005.180
  16. Izmirly PM, 2012, CIRCULATION, V126, P76, DOI 10.1161/CIRCULATIONAHA.111.089268
  17. Izmirly PM, 2011, CIRCULATION, V124, P1927, DOI 10.1161/CIRCULATIONAHA.111.033894
  18. LEROY EC, 1980, ARTHRITIS RHEUM, V23, P341, DOI 10.1002/art.1780230312
  19. Lesmes C, 2015, ULTRASOUND OBST GYN, V46, P198, DOI 10.1002/uog.14826
  20. Lunardi F, 2011, DIAGN PATHOL, V6, DOI 10.1186/1746-1596-6-50
  21. Mosca A, 2006, AUTOIMMUN REV, V6, P1, DOI 10.1016/j.autrev.2006.03.004
  22. Mosca M, 2002, LUPUS, V11, P304, DOI 10.1191/0961203302lu187oa
  23. Mosca M, 2007, BEST PRACT RES CL RH, V21, P1011, DOI 10.1016/j.berh.2007.09.004
  24. Mosca M, 2014, J AUTOIMMUN, V48-49, P50, DOI 10.1016/j.jaut.2014.01.019
  25. Nybo Andersen AM, BMJ
  26. Radin M, 2019, RHEUMATOLOGY, V58, P2000, DOI 10.1093/rheumatology/kez141
  27. Spinillo A, 2008, BJOG-INT J OBSTET GY, V115, P51, DOI 10.1111/j.1471-0528.2007.01530.x
  28. Spinillo A, 2016, BMC PREGNANCY CHILDB, V16, DOI 10.1186/s12884-016-1076-8
  29. Spinillo A, 2008, AM J OBSTET GYNECOL, V199, DOI 10.1016/j.ajog.2008.05.008
  30. Taraborelli M, 2012, ARTHRITIS RHEUM-US, V64, P1970, DOI 10.1002/art.34350

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/17
Artigos e Materiais de Revistas Científicas - ODS/03