Adverse Pregnancy Outcomes in Sjogren's Disease Compared to Controls: An Interdisciplinary Approach with Maternal-Fetal Medicine

Abstract

Objectives Outside of the association of SS-A antibody with congenital heart block, little is known about adverse maternal and neonatal outcomes, in patients with Sjogren's disease (SjD). Our study involved collaboration with maternal-fetal medicine (MFM). Methods A retrospective cohort study of pregnant patients: SjD patients were matched 1:3 with non-SjD controls. SjD patients were included by meeting the 2016 ACR/EULAR Criteria or by a rheumatologist diagnosis. Exclusion criteria were concurrent autoimmune disease or related antibodies. A composite of grouped outcomes was utilized and verified by MFM specialists. The primary outcome was adverse pregnancy outcome (APO) between the two groups. Statistical analysis was performed using a two-sample t -test and Fisher's exact test. Results 48 patients were included: 12 SjD patients and 36 controls. APO was significantly increased in SjD with one preterm birth, one fetal growth restriction, and one limb anomaly; non-SjD had one cardiac anomaly. There were no cases of CHB. SjD patients were more likely to be delivered by cesarean delivery. Conclusion There was an increased risk of APO in SjD patients compared with controls. No significant difference in neonatal outcomes was found. We speculate that placental pathology may play a role in pathophysiology and future studies should be performed. Key Points There was an increased risk of APO in SjD patients compared with controls. No significant difference in neonatal outcomes was found. We speculate that placental pathology may play a role in pathophysiology, prompting future studies.