title: Pregnancy outcome of 126 anti-SSA/Ro-positive patients during the past 24 years--a retrospective cohort study.
abstract: The aims of our study are to observe the pregnancy outcome of anti-Sjögren's syndrome-related antigen A (SSA)/Ro-positive women and to predict the risk factors for adverse pregnancy outcome and neonatal lupus erythematosus (NLE). Clinical data of 126 anti-SSA/Ro-positive patients with 140 pregnancies were evaluated retrospectively, and the newborns were followed up as a cohort in 3 months. χ (2) test or logistic regression was used to predict the risk factors of lupus flares during pregnancy, fetal loss, and NLE. Twenty-six out of 93 pregnancies with systemic lupus erythematosus (SLE) experienced flares during pregnancy. Active disease prior to conception was the independent risk factor for flares [P = 0.002, odds ratio (OR) = 10.41 (95 % confidence interval (CI) = 2.34∼46.26)]. Continuous use of steroids and hydroxychloroquine (HCQ) might help decrease the risk (P = 0.041 and 0.015, respectively). Eleven out of 140 pregnancies ended with fetal loss, and 9 out of 113 live births were diagnosed with NLE. The presence of anti-phospholipid syndrome (APS) was associated with fetal loss (P = 0.018, OR = 6.41 (95 % CI = 1.57-26.14)). The presence of anti-Sjögren's syndrome-related antigen B (SSB)/La antibodies tended to increase the risk of giving birth to an infant with NLE (P = 0.140); on the other hand, duration of disease, history of renal involvement, and active SLE during pregnancy did not contribute to the incidence of NLE (P = 0.649, 0.685, and 1.000, respectively). Active disease without regular follow-up before conception significantly increased the risk of lupus flares during pregnancy. The continuous use of low-dose steroids and hydroxychloroquine might help maintain lower SLE activity. Concurrent APS instead of high titer of anti-SSA/Ro might raise the risk of fetal loss in anti-SSA/Ro-positive patients.
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Beijing, China.|Department of Rheumatology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Beijing, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Beijing, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Fei
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Beijing, China.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Beijing, China.
authors.forename: Donglin
authors.initials: D
authors.lastname: Hao
authors.affiliation: Department of Rheumatology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Beijing, China. zhaoyan_pumch2002@aliyun.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000097:blood; D003240:Connective Tissue Diseases / Q000150:complications; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000150:complications* / Q000151:congenital* / Q000175:diagnosis; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012261:Ribonucleoproteins / Q000097:blood*; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D055815:Young Adult; D000099207:SS-A Antigen
chemical_list: D000974:Antibodies, Antinuclear; D006886:Hydroxychloroquine; D012261:Ribonucleoproteins; D013256:Steroids; D000099207:SS-A Antigen
keywords: Anti-SSA/Ro antibodies; Connective tissue disease (CTD); Neonatal lupus erythematosus; Pregnancy; SLE