Rheumatology Unit and Department of Gynecology and Obstetrics, Sapienza University, Rome, Italy.
J Rheumatol. 2013 Jul;40(7):1143-7. doi: 10.3899/jrheum.121518. Epub 2013 Jun 1.
To investigate pregnancy and fetal outcomes in patients with primary Sjögren syndrome (pSS).
An obstetric history of 36 women with established diagnosis of pSS at pregnancy was obtained from a multicenter cohort of 1075 patients. In a subgroup case-control analysis, 12 deliveries in patients with pSS were compared with 96 control deliveries.
Thirty-six women (31 with anti-SSA/Ro and/or anti-SSB/La antibodies) with an established diagnosis of pSS had 45 pregnancies with the delivery of 40 newborns. Two miscarriages, 2 fetal deaths, and 1 induced abortion were recorded. Mean age at the first pregnancy was 33.9 years; mean number of pregnancies was 1.25; 18/40 (45%) cesarean births were delivered; mean pregnancy length was 38.5 weeks (range 32-43), with 6 preterm deliveries. The mean Apgar score at 5 min was 8.9, mean birthweight was 2920 g (range 826-4060 g). Congenital heart block (CHB) occurred in 2/40 (5%) newborns. The reported rate of breastfeeding for at least 1 month was 60.5%. In 4/40 pregnancies (10%) a flare of disease activity was observed within a year from delivery. In the case-control subgroup analysis, 12 deliveries were compared with 96 controls and no significant differences were found.
Patients with pSS can have successful pregnancies, which might be followed by a mild relapse. CHB was the only cause of death for offspring of mothers with pSS.
研究原发性干燥综合征（pSS）患者的妊娠和胎儿结局。
从 1075 例患者的多中心队列中获得了 36 名确诊为 pSS 的孕妇的产科病史。在亚组病例对照分析中，将 12 例 pSS 患者的分娩与 96 例对照分娩进行了比较。
36 名（31 名抗 SSA/Ro 和/或抗 SSB/La 抗体阳性）确诊为 pSS 的女性有 45 次妊娠，分娩了 40 名新生儿。记录了 2 次流产、2 例胎儿死亡和 1 例人工流产。第一次妊娠的平均年龄为 33.9 岁；平均妊娠次数为 1.25 次；18/40（45%）剖宫产分娩；平均妊娠长度为 38.5 周（范围 32-43 周），有 6 例早产。5 分钟时平均 Apgar 评分为 8.9，平均出生体重为 2920 克（范围 826-4060 克）。2 名新生儿（5%）发生先天性心脏传导阻滞（CHB）。报告的至少母乳喂养 1 个月的比例为 60.5%。在 4/40 例（10%）妊娠中，在分娩后 1 年内观察到疾病活动的轻度复发。在病例对照亚组分析中，将 12 例分娩与 96 例对照进行了比较，未发现显著差异。
pSS 患者可以成功妊娠，随后可能会出现轻度复发。CHB 是母亲患有 pSS 的后代死亡的唯一原因。
