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Vol. 224. Issue 6.
Pages 357-365 (June - July 2024)
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Vol. 224. Issue 6.
Pages 357-365 (June - July 2024)
Original article
Comparing pregnancy outcomes in patients with Systemic Lupus Erythematosus (SLE) and Undifferentiated Connective Tissue Disease (UCTD): a descriptive cohort study
Comparativa de resultados obstétricos en pacientes con Lupus Eritematoso Sistémico (LES) y enfermedad indiferenciada del tejido conectivo (UCTD): un estudio de cohorte descriptivo
Candido Muñoz Muñoza,b,
Corresponding author
drcandidomunoz@gmail.com

Corresponding authors.
, Filipa Farinhaa,c, Thomas McDonnelld, Hajar J'baria, Hanh Nguyena, David Isenberga, Anisur Rahmana, David Williamse, Jaume Alijotas-Reigb,
Corresponding author
jaume.alijotas@vallhebron.cat

Corresponding authors.
, Ian Gilesa
a Centre for Rheumatology, Division of Medicine, University College London, London, UK
b Systemic Autoimmune Disease Unit, Department of Medicine, Vall d'Hebron University Hospital, Barcelona, Spain
c Rheumatology, Hospital Distrital de Santarém, Santarém, Portugal
d Department of Biochemical Engineering, University College London, London, UK
e Women’s Health, University College London Hospital NHS Foundation Trust, London, UK
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Figures (1)
Tables (4)
Table 1. Definitions and abbreviations.
Table 2. Disease characteristics, baseline variables and pregnancy outcomes (at the time of the latest pregnancy) in patients with SLE and UCTD.
Table 3. Past obstetric outcomes in patients with SLE and UCTD.
Table 4. CHB or other cardiac abnormalities (including only patients with positive anti-Ro).
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Abstract
Background

Females diagnosed with systemic lupus erythematosus (SLE) face an elevated risk of adverse pregnancy outcomes (APOs). However, the evidence regarding whether a similar association exists in patients with undifferentiated connective tissue disease (UCTD) is inconclusive.

Methods

We conducted a retrospective review (2006–2019) of pregnancy outcomes among patients with SLE (n = 51) and UCTD (n = 20) within our institution. We examined the occurrence of various APOs, encompassing miscarriage, stillbirth, termination, preterm birth, pre-eclampsia, eclampsia, HELLP syndrome, intrauterine growth restriction, abruption placentae, congenital heart block, or other cardiac abnormalities.

Results

The mean age at pregnancy was 35 ± 7.0 years for patients with SLE and 35 ± 6.8 years for those with UCTD (p = 0.349). The proportion of Caucasian women was 47% in SLE and 80% in UCTD. Pregnancies in both groups were planned (81% in SLE and 77% in UCTD), and patients presented with inactive disease at conception (96% in SLE and 89% in UCTD). Hydroxychloroquine at conception was utilized by 86% of women with SLE, in contrast to 36% in the UCTD group. Both, SLE and UCTD cohorts exhibited low rates of disease flares during pregnancy and/or puerperium (14% vs. 10%). The incidence of APOs was 15.6% in SLE patients compared to 5% in those with UCTD (Risk difference 19.5%; 95% confidence interval: −3.9 to 43.1; p = 0.4237).

Conclusion

Our study underscores the importance of strategic pregnancy planning and the maintenance of appropriate treatment throughout pregnancy to ensure optimal disease management and minimize adverse outcomes in both SLE and UCTD pregnancies.

Keywords:
Adverse pregnancy outcomes
Undifferentiated connective tissue disease
Systemic lupus erythematosus
Resumen
Introducción

Las mujeres con lupus eritematoso sistémico (LES) presentan un riesgo elevado de resultados adversos en el embarazo (APO). Sin embargo, la evidencia científica es inconclusa si este riesgo también existe en pacientes con enfermedad del tejido conectivo no diferenciada (UCTD).

Métodos

Realizamos una revisión retrospectiva (2006–2019) de los resultados del embarazo entre pacientes con LES (n = 51) y UCTD (n = 20. Examinamos la ocurrencia de varios APO: aborto espontáneo, mortinato, terminación, parto prematuro, preeclampsia, eclampsia, síndrome HELLP, restricción del crecimiento intrauterino, desprendimiento de placenta, bloqueo cardíaco congénito u otras anomalías cardíacas.

Resultados

La edad media en el embarazo fue de 35 ± 7.0 años para pacientes con LES y 35 ± 6.8 años para UCTD (p = 0.349). La proporción de mujeres caucásicas fue del 47% en LES y del 80% en UCTD. Los embarazos fueron mayoritariamente planificados (81% en LES y 77% en UCTD), y la enfermedad inactiva en la concepción (96% en LES y 89% en UCTD). La hidroxicloroquina en la concepción fue utilizada por el 86% en pacientes con LES vs. 36% en UCTD. Tanto las cohortes de LES como de UCTD presentaron tasas bajas de brotes de la enfermedad durante el embarazo y/o puerperio (14% vs 10%). La incidencia de APO fue del 15.6% en LES vs. el 5% en UCTD (Diferencia de riesgo 19.5%; Intervalo de Confianza del 95%: -3.9 a 43.1; p = 0.4237).

Conclusión

Nuestro estudio subraya la importancia una correcta planificación y mantenimiento del tratamiento adecuado durante el embarazo para minimizar el riesgo de APO en ambos grupos.

Palabras clave:
Resultados adversos del embarazo
Enfermedad del tejido conectivo indiferenciado
Lupus eritematoso sistémico

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