Медицинская библиотека · RMD open · 2024

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.

Andreoli Laura, Gerardi Maria Chiara, Gerosa Maria, Rozza Davide, Crisafulli Francesca, Erra Roberta, Lini Daniele, Trespidi Laura, Padovan Melissa, Ruffilli Francesca, Serale Francesca, Cuomo Giovanna, Raffeiner Bernd, Semeraro Paolo, Tani Chiara, Chimenti Maria Sole, Conigliaro Paola, Hoxha Ariela, Nalli Cecilia, Fredi Micaela, Lazzaroni Maria Grazia, Filippini Matteo, Taglietti Marco, Franceschini Franco, Zatti Sonia, Loardi Chiara, Orabona Rossana, Ramazzotto Francesca, Zanardini Cristina, Fontana Giulia, Gozzoli Giorgia, Barison Claudia, Bizioli Paola, Caporali Roberto Felice, Carrea Giulia, Ossola Manuela Wally, Maranini Beatrice, Silvagni Ettore, Govoni Marcello, Morano Danila, Verteramo Rosita, Doria Andrea, Del Ross Teresa, Favaro Maria, Calligaro Antonia, Tonello Marta, Larosa Maddalena, Zen Margherita, Zambon Alessandra, Mosca Marta, Zucchi Dina, Elefante Elena, Gori Sabrina, Iannone Florenzo, Anelli Maria Grazia, Lavista Marlea, Abbruzzese Anna, Fasano Carlo Giuseppe, D'Angelo Salvatore, Cutro Maria Stefania, Picerno Valentina, Carbone Teresa, Padula Angela Anna, Rovere-Querini Patrizia, Canti Valentina, De Lorenzo Rebecca, Cavallo Ludovica, Ramoni Véronique, Montecucco Carlomaurizio, Codullo Veronica, Milanesi Alessandra, Pazzola Giulia, Comitini Giuseppina, Marvisi Chiara, Salvarani Carlo, Epis Oscar Massimiliano, Benedetti Sara, Di Raimondo Giuseppina, Gagliardi Clizia, Lomater Claudia, Crepaldi Gloria, Bellis Elisa, Bellisai Francesca, Garcia Gonzalez Estrella, Pata Anna Paola, Zerbinati Martina, Urban Maria Letizia, Mattioli Irene, Iuliano Annamaria, Sebastiani Giandomenico, Brucato Antonio Luca, Bizzi Emanuele, Cutolo Maurizio, Santo Leonardo, Tonetta Sara, Landolfi Gianpiero, Carrara Greta, Bortoluzzi Alessandra, Scirè Carlo Alberto, Tincani Angela, P-RHEUM.it Investigators of the Italian Society for Rheumatology (SIR)

СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАПеревод в очереди

Аннотация

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.

Для цитирования: Andreoli Laura, Gerardi Maria Chiara, Gerosa Maria, Rozza Davide, Crisafulli Francesca, Erra Roberta, Lini Daniele, Trespidi Laura, Padovan Melissa, Ruffilli Francesca, Serale Francesca, Cuomo Giovanna, Raffeiner Bernd, Semeraro Paolo, Tani Chiara, Chimenti Maria Sole, Conigliaro Paola, Hoxha Ariela, Nalli Cecilia, Fredi Micaela, Lazzaroni Maria Grazia, Filippini Matteo, Taglietti Marco, Franceschini Franco, Zatti Sonia, Loardi Chiara, Orabona Rossana, Ramazzotto Francesca, Zanardini Cristina, Fontana Giulia, Gozzoli Giorgia, Barison Claudia, Bizioli Paola, Caporali Roberto Felice, Carrea Giulia, Ossola Manuela Wally, Maranini Beatrice, Silvagni Ettore, Govoni Marcello, Morano Danila, Verteramo Rosita, Doria Andrea, Del Ross Teresa, Favaro Maria, Calligaro Antonia, Tonello Marta, Larosa Maddalena, Zen Margherita, Zambon Alessandra, Mosca Marta, Zucchi Dina, Elefante Elena, Gori Sabrina, Iannone Florenzo, Anelli Maria Grazia, Lavista Marlea, Abbruzzese Anna, Fasano Carlo Giuseppe, D'Angelo Salvatore, Cutro Maria Stefania, Picerno Valentina, Carbone Teresa, Padula Angela Anna, Rovere-Querini Patrizia, Canti Valentina, De Lorenzo Rebecca, Cavallo Ludovica, Ramoni Véronique, Montecucco Carlomaurizio, Codullo Veronica, Milanesi Alessandra, Pazzola Giulia, Comitini Giuseppina, Marvisi Chiara, Salvarani Carlo, Epis Oscar Massimiliano, Benedetti Sara, Di Raimondo Giuseppina, Gagliardi Clizia, Lomater Claudia, Crepaldi Gloria, Bellis Elisa, Bellisai Francesca, Garcia Gonzalez Estrella, Pata Anna Paola, Zerbinati Martina, Urban Maria Letizia, Mattioli Irene, Iuliano Annamaria, Sebastiani Giandomenico, Brucato Antonio Luca, Bizzi Emanuele, Cutolo Maurizio, Santo Leonardo, Tonetta Sara, Landolfi Gianpiero, Carrara Greta, Bortoluzzi Alessandra, Scirè Carlo Alberto, Tincani Angela, P-RHEUM.it Investigators of the Italian Society for Rheumatology (SIR). 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. 2024. DOI: 10.1136/rmdopen-2024-004091.

Предметные рубрики MeSH

Adult Female Humans Infant, Newborn Pregnancy Antirheumatic Agents Autoimmune Diseases Glucocorticoids Hydroxychloroquine Italy Pregnancy Complications Pregnancy Outcome Prospective Studies Rheumatic Diseases

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