Preterm Delivery a Risk in Systemic Sclerosis PDF Print E-mail
Thursday, 05 January 2012 08:08
Taken from http://www.flickr.com/photos/thousand_birds/4482649498/ via creative commonsMany women with systemic sclerosis can have successful pregnancies, but the rates of preterm birth, low birth weight, and intrauterine growth restriction are approximately twice as high in these women compared to the general population of pregnant women, based on data from 109 pregnancies in 99 women with systemic sclerosis. The findings were published in December's Arthritis & Rheumatism.

Data from previous studies have suggested negative outcomes for pregnancies in women with systemic sclerosis (SSc), but these have been small case series or large database reviews that did not allow for the identification of individual patients, said Dr. Mara Taraborelli of Spedali Civili and University, Brescia, Italy, and colleagues.

In this prospective study, the researchers followed 99 women with SSc who had 109 pregnancies between 2000 and 2011. The women attended one of 25 participating research centers in Italy.

The average age at conception was 32 years, and most of the women were white. A total of 107 pregnancies were spontaneous, and 2 were achieved with assisted reproductive techniques.

Preterm deliveries were significantly more common in the SSc women, compared to the general obstetric population that served as a control group (25% vs. 12%, respectively). Severe preterm delivery (defined as delivery at less than 34 weeks) also was significantly more common in SSc women, compared to the controls (10% vs. 5%, respectively).

In addition, very low birth weight babies and cases of intrauterine growth restriction were significantly more common in the SSc women, compared to the controls (5% vs. 1%, respectively, and 6% vs. 1%, respectively).

The researchers found no increase in hypertensive disorders of pregnancy or spontaneous pregnancy losses in SSc women, compared to the general pregnant population.

"We observed a low rate of disease progression shortly after the end of pregnancy; this risk might be greater in aSCL-70 positive patients with recent-onset disease," the researchers noted. All four cases of internal organ disease evolution within 12 months after delivery occurred in women who were aSCL-70 positive, and 3 of 23 (13%) of women who were aSCL-70 positive whose disease had lasted less than 3 years had some disease progression after delivery.

A total of six newborns spent a median of 15 days in the intensive care unit. Of these, one was severely premature and died of multi-organ failure.

The study findings were limited by the use of retrospective analysis and the use of controls for only one year, but the results suggest that successful pregnancies are possible for SSc women despite the increased risks for poor maternal and fetal outcomes, with multidisciplinary management, the researchers said. However, pregnancy may not be advisable for patients with severe organ damage or recent onset of SSc, especially those who are antitopoisomerase positive, they added.

Source: Splete, H. (2012), "Preterm Delivery a Risk in Systemic Sclerosis", Family Practice News;


 
More articles :

» Researchers Find Small Group Of ANA & RP Negative Patients

There exists a very small subgroup of patients with (SSc) who lack circulating (ANA) and who do not have Raynaud's phenomenon (RP), research shows. These patients also fail to meet any of the diagnostic criteria for known SSc mimics.The...

» Oral Health of Chinese People with Systemic Sclerosis

Clive M. K. Yeung; Ian A. Lai; C. H. Chu; W. Keung Leung; Mo Yin MokThe University of Hong KongReceived: 22 July 2010 / Accepted: 28 September 2010 / Published online: 12 October 2010Scleroderma is a symptom of a group of diseases that involve the...

» PUVA Therapy In The Treatment of Localized Scleroderma

In localized , disease activity would tend to stop spontaneously over time. Treatment is important to reduce disabilities caused by the active phases of disease. According to , there are three treatments used in the treatment of localized...

» Getting to the Root of Raynaud’s

Dr. Fredrick Wigley is a professor of medicine at Johns Hopkins School of Medicine and director of the Johns Hopkins Scleroderma  Center. A rheumatologist, he has been studying Raynaud’s since 1978. The New York Times recently interviewed Dr....

» Scleroderma Renal Crisis: A Pathology Perspective

Ibrahim Batal, Robyn T. Domsic, Thomas A.Medsger Jr., and Sheldon BastackyInternational Journal of RheumatologyVolume 2010, Article ID 543704Scleroderma renal crisis (SRC) is an infrequent but serious complication of systemic sclerosis (SSc). It is...

» A Checklist For Scleroderma Patients

The has published a quite useful checklist of items, which has been found useful to patients. They have noted that the list is by no means comprehensive, but is intended as a guideline to assist Scleroderma patients, and was developed by patients...