%0 Journal Article
%T 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.
%A Andreoli L
%A Gerardi MC
%A Gerosa M
%A Rozza D
%A Crisafulli F
%A Erra R
%A Lini D
%A Trespidi L
%A Padovan M
%A Ruffilli F
%A Serale F
%A Cuomo G
%A Raffeiner B
%A Semeraro P
%A Tani C
%A Chimenti MS
%A Conigliaro P
%A Hoxha A
%A Nalli C
%A Fredi M
%A Lazzaroni MG
%A Filippini M
%A Taglietti M
%A Franceschini F
%A Zatti S
%A Loardi C
%A Orabona R
%A Ramazzotto F
%A Zanardini C
%A Fontana G
%A Gozzoli G
%A Barison C
%A Bizioli P
%A Caporali RF
%A Carrea G
%A Ossola MW
%A Maranini B
%A Silvagni E
%A Govoni M
%A Morano D
%A Verteramo R
%A Doria A
%A Del Ross T
%A Favaro M
%A Calligaro A
%A Tonello M
%A Larosa M
%A Zen M
%A Zambon A
%A Mosca M
%A Zucchi D
%A Elefante E
%A Gori S
%A Iannone F
%A Anelli MG
%A Lavista M
%A Abbruzzese A
%A Fasano CG
%A D'Angelo S
%A Cutro MS
%A Picerno V
%A Carbone T
%A Padula AA
%A Rovere-Querini P
%A Canti V
%A De Lorenzo R
%A Cavallo L
%A Ramoni V
%A Montecucco C
%A Codullo V
%A Milanesi A
%A Pazzola G
%A Comitini G
%A Marvisi C
%A Salvarani C
%A Epis OM
%A Benedetti S
%A Di Raimondo G
%A Gagliardi C
%A Lomater C
%A Crepaldi G
%A Bellis E
%A Bellisai F
%A Garcia Gonzalez E
%A Pata AP
%A Zerbinati M
%A Urban ML
%A Mattioli I
%A Iuliano A
%A Sebastiani G
%A Brucato AL
%A Bizzi E
%A Cutolo M
%A Santo L
%A Tonetta S
%A Landolfi G
%A Carrara G
%A Bortoluzzi A
%A Scirè CA
%A Tincani A
%A  
%J RMD Open
%V 10
%N 2
%D 2024 Apr 24
%M 38663885
%F 5.806
%R 10.1136/rmdopen-2024-004091
%X <B>OBJECTIVE: </B>To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.