Pregnancy outcome in joint hypermobility syndrome and Ehlers–Danlos syndrome

Abstract

Introduction: An increased risk of preterm birth in women with joint hypermobility syndrome or Ehlers–Danlos syndrome is suspected. Material and methods: In this nationwide cohort study from 1997 through 2011, women with either joint hypermobility syndrome or Ehlers–Danlos syndrome or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby, 314 singleton births to women with joint hypermobility syndrome/Ehlers–Danlos syndrome before delivery were identified. These births were compared with 1 247 864 singleton births to women without a diagnosis of joint hypermobility syndrome/Ehlers–Danlos syndrome. We used logistic regression, adjusted for maternal age, smoking, parity, and year of birth, to calculate adjusted odds ratios for adverse pregnancy outcomes. Results: Maternal joint hypermobility syndrome/Ehlers–Danlos syndrome was not associated with any of our outcomes: preterm birth (adjusted odds ratio = 0.6, 95% confidence interval 0.3–1.2), preterm premature rupture of membranes (adjusted odds ratio = 0.8; 95% confidence interval 0.3–2.2), cesarean section (adjusted odds ratio = 0.9, 95% confidence interval 0.7–1.2), stillbirth (adjusted odds ratio = 1.1, 95% confidence interval 0.2–7.9), low Apgar score (adjusted odds ratio = 1.6, 95% confidence interval 0.7–3.6), small for gestational age (adjusted odds ratio = 0.9, 95% confidence interval 0.4–1.8) or large for gestational age (adjusted odds ratio = 1.2, 95% confidence interval 0.6–2.1). Examining only women with Ehlers–Danlos syndrome (n = 62), we found a higher risk of induction of labor (adjusted odds ratio = 2.6; 95% confidence interval 1.4–4.6) and amniotomy (adjusted odds ratio = 3.8; 95% confidence interval 2.0–7.1). No excess risks for adverse pregnancy outcome were seen in joint hypermobility syndrome. Conclusion: Women with joint hypermobility syndrome/Ehlers–Danlos syndrome do not seem to be at increased risk of adverse pregnancy outcome.