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
Authors' conclusion
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.
Study context
- Population
- Pregnant women with autoimmune rheumatic diseases (ARD) enrolled up to 20 gestational weeks, 29 Italian Rheumatology Centres, 2018–2023 (P-RHEUM.it)866 pregnancies analysed
- Participants
- 851 women
- Outcome
- Pregnancy outcomes in women with ARD
Methodological detailsmulticentre, 29 Rheumatology Centres, web-based database
- Multicentre
- 29 Rheumatology Centres
- Web-based database
Main finding
As reported in the abstract
Pregnancy outcomes
- Maternal disease flares, pregnancies
- 135 (15.6%)
- Pregnancies induced by assisted reproduction techniques
- 53 (6.1%)
- Miscarriage
- 61 (7%)
- Elective termination
- 11 (1.3%)
- Obstetrical complications
- 261 (30.1%)
- Pre-eclampsia
- 2.3%
- Congenital heart block among 157 pregnancies with anti-Ro/SSA
- 2 (1.3%)
- Live births
- 794 (91.7%)
- Live births at term
- 84.9%
- Perinatal deaths
- 4 (0.5%)
- Small-for-gestational-age, among 790 newborns
- 31 (3.9%)
- Perinatal complications, among 790 newborns
- 169 (21.4%)
Observational data: associations, not effects.
Further findings
Medication use during pregnancy
- GC
- 244 (28.2%)
- HCQ
- 388 (44.8%)
- csDMARD
- 85 (9.8%)
- bDMARD
- 122 (14.1%)
Exclusive maternal breast feeding
- Neonates exclusively breast fed
- 404 (46.7%)
Postnatal emotional distress (Edinburgh Postnatal Depression Scale)
- Women completing the scale
- 414 (52.4%)
- Scored positive for emotional distress
- 89 (21.5%)
Original publication
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. RMD Open. Published 24 April 2024. doi:10.
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