Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospectiveItalian P-RHEUM.it study

被引：0

作者：

Andreoli, Laura ^{[1
,2
]}

Gerardi, Maria Chiara ^{[3
]}

Gerosa, Maria ^{[4
,5
]}

Rozza, Davide ^{[6
]}

Crisafulli, Francesca ^{[1
,2
]}

Erra, Roberta ^{[7
]}

Lini, Daniele ^{[1
,2
]}

Trespidi, Laura ^{[7
]}

Padovan, Melissa ^{[8
]}

Ruffilli, Francesca ^{[8
]}

Serale, Francesca ^{[9
]}

Cuomo, Giovanna ^{[10
]}

Raffeiner, Bernd ^{[11
]}

Semeraro, Paolo ^{[1
,2
]}

Tani, Chiara ^{[12
]}

Chimenti, Maria Sole ^{[13
]}

Conigliaro, Paola ^{[13
]}

Hoxha, Ariela ^{[14
]}

Nalli, Cecilia ^{[1
,2
]}

Fredi, Micaela ^{[1
,2
]}

Lazzaroni, Maria Grazia ^{[1
,2
]}

Filippini, Matteo ^{[1
,2
]}

Taglietti, Marco ^{[1
,2
]}

Franceschini, Franco ^{[1
,2
]}

Zatti, Sonia ^{[15
]}

Loardi, Chiara ^{[15
]}

Orabona, Rossana ^{[15
]}

Ramazzotto, Francesca ^{[15
]}

Zanardini, Cristina ^{[15
]}

Fontana, Giulia ^{[1
,2
]}

Gozzoli, Giorgia ^{[1
,2
]}

Barison, Claudia ^{[1
,2
]}

Bizioli, Paola ^{[1
,2
]}

Caporali, Roberto Felice ^{[4
,5
]}

Carrea, Giulia ^{[4
,5
]}

Ossola, Manuela Wally ^{[7
]}

Maranini, Beatrice ^{[8
]}

Silvagni, Ettore ^{[8
]}

Govoni, Marcello ^{[8
]}

Morano, Danila ^{[16
]}

Verteramo, Rosita ^{[17
]}

Doria, Andrea ^{[18
]}

Del Ross, Teresa ^{[18
]}

Favaro, Maria ^{[18
]}

Calligaro, Antonia ^{[18
]}

Tonello, Marta ^{[18
]}

Larosa, Maddalena ^{[18
,19
]}

Zen, Margherita ^{[18
]}

Zambon, Alessandra ^{[20
]}

Mosca, Marta ^{[12
]}

机构：

[1] ASST Spedali Civili, Rheumatol & Clin Immunol Unit, ERN ReCONNET, Brescia, Italy

[2] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[3] Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy

[4] ASST Gaetano Pini CTO, Clin Rheumatol Div, Milan, Italy

[5] Univ Milan, Res Ctr Adult & Pediat Rheumat Dis RECAP RD, Dept Clin Sci & Community Hlth, Milan, Italy

[6] Italian Soc Rheumatol, Epidemiol Res Unit, Milan, Italy

[7] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Obstet & Gynaecol, Milan, Italy

[8] Univ Ferrara, Dept Med Sci, Rheumatol Unit, Azienda Osped Univ S Anna Ferrara, Ferrara, Italy

[9] ASL CN1, Rheumatol Unit, Cuneo, Italy

[10] Univ Campania L Vanvitelli, Precis Med Dept, Naples, Italy

[11] Paracelsus Med Univ PMU, Cent Hosp Bolzano SABES ASDAA, Dept Rheumatol, Teaching Hosp, Bolzano, Italy

[12] Univ Pisa, Dept Clin & Expt Med, Rheumatol Unit, Pisa, Italy

[13] Univ Roma Tor Vergata, Dept Syst Med Rheumatol Allergol & Clin Immunol, Rome, Italy

[14] Univ Padua, Dept Med, Gen Med & Thrombosis & Hemorrhag Unit, Padua, Italy

[15] ASST Spedali Civili, Dept Obstet & Gynecol, Brescia, Italy

[16] Univ Ferrara, Azienda Osped Univ S Anna, Dipartimento Materno Infantile, Obstet & Gynecol Unit, Ferrara, Italy

[17] AUSL Ferrara, UO Serv Sanit 1, Dipartimento Cure Primarie, Ferrara, Italy

[18] Univ Padua, Dept Med, Rheumatol Unit, Padua, Italy

[19] Azienda Sanit Locale 3 Genovese, Dept Med Specialties, Div Rheumatol, Genoa, Italy

[20] Univ Padua, Dept Woman & Child Hlth, Unit Obstet & Gynecol, Padua, Italy

[21] Univ Bari, Rheumatol Unit, DiMePRe J, Bari, Italy

[22] Lucania San Carlo Hosp, Rheumatol Dept, Potenza, Italy

[23] San Carlo Hosp, Immunopathol Lab, Potenza, Italy

[24] IRCCS Osped San Raffaele, Div Immunol Transplantat & Infect Dis, Milan, Italy

[25] ASST Lodi Osped Maggiore Lodi, Internal Med Dept, Lodi, Italy

[26] Fdn IRCCS Policlin San Matteo, Div Rheumatol, Pavia, Italy

[27] Univ Pavia, PhD Program Expt Med, Pavia, Italy

[28] Azienda USL IRCCS Reggio Emilia, Rheumatol Unit, Reggio Emilia, Italy

[29] Azienda USL IRCCS Reggio Emilia, Dept Obstet & Gynecol, Reggio Emilia, Italy

[30] Univ Modena & Reggio Emilia, PhD Program Clin Expt Med, Modena, Italy

[31] Univ Modena & Reggio Emilia, Dept Surg Med Dent & Morphol Sci Interest Transpl, Modena, Emilia Romagna, Italy

[32] Grande Osped Metropolitano Niguarda, Maternal Infant Dept, Obstet & Gynecol, Milan, Italy

[33] AO Mauriziano Torino, Acad Rheumatol Ctr, Turin, Italy

[34] Univ Turin, Dept Clin & Biol Sci, Turin, Italy

[35] Univ Siena, Dept Med Surg & Neurosci, Rheumatol Unit, Siena, Italy

[36] Univ Florence, Dept Expt & Clin Med, Florence, Italy

[37] San Camillo Forlanini Hosp, Rheumatol Unit, Rome, Italy

[38] Univ Milan, Fatebenefratelli Hosp, ASST Fatebenefratelli Sacco, Div Internal Med, Milan, Italy

[39] Univ Milan, Dept Biomed & Clin Sci, Milan, Italy

[40] Univ Genoa, IRCCS San Martino Polyclin Hosp, Dept Internal Med & Specialties, Lab Expt Rheumatol, Genoa, Italy

[41] Univ Genoa, IRCCS San Martino Polyclin Hosp, Dept Internal Med & Specialties, Acad Div Clin Rheumatol, Genoa, Italy

[42] Mons Dimiccoli Hosp, Rheumatol Unit, Barletta, BT, Italy

[43] Santa Chiara Reg Hosp, Unit Rheumatol, APSS, Trento, Italy

[44] IRCCS San Gerardo Dei Tintori Fdn, Rheumatol Unit, Milan, Italy

[45] Bicocca Univ, Sch Med, Milan, Italy

来源：

RMD OPEN | 2024年 / 10卷 / 02期

关键词：

autoimmune diseases; connective tissue diseases; systemic vasculitis; antirheumatic agents; arthritis; SYSTEMIC-LUPUS-ERYTHEMATOSUS; EULAR RECOMMENDATIONS; PREECLAMPSIA; ARTHRITIS; HEALTH; REMISSION;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures.

引用

页数：17