{Reference Type}: Journal Article
{Title}: A multicentre study of 244 pregnancies in undifferentiated connective tissue disease: maternal/fetal outcomes and disease evolution.
{Author}: Radin M;Schreiber K;Cecchi I;Bortoluzzi A;Crisafulli F;de Freitas CM;Bacco B;Rubini E;Foddai SG;Padovan M;Gallo Cassarino S;Franceschini F;Andrade D;Benedetto C;Govoni M;Bertero T;Marozio L;Roccatello D;Andreoli L;Sciascia S;
{Journal}: Rheumatology (Oxford)
{Volume}: 59
{Issue}: 9
{Year}: 09 2020 1
{Factor}: 7.046
{DOI}: 10.1093/rheumatology/kez620
{Abstract}: To investigate fetal/perinatal and maternal outcomes from a large multicentre cohort of women diagnosed with UCTD.<BR>This multicentre retrospective cohort study describes the outcomes of 224 pregnancies in 133 consecutive women with a diagnosis of UCTD, positive for ANA and aged <45 years old at study inclusion.<BR>Of the 224 pregnancies analysed, 177 (79%) resulted in live births, 45 (20.1%) in miscarriages (defined as pregnancy loss before 12 weeks' gestation), 2 (0.9%) in stillbirths (pregnancy loss after 20 weeks' gestation) and 6 (2.7%) cases showed intrauterine growth restriction. Miscarriages and stillbirths were strongly associated with the presence of aPL and ENA antibodies (P < 0.05). Maternal pregnancy complications were as follows: 5 (2.2%) cases developed pre-eclampsia, 11 (4.9%) cases gestational hypertension and 12 (5.4%) cases gestational diabetes. Joint involvement represented the most frequent clinical manifestation of the cohort (57.9%), followed by RP (40.6%), photosensitivity (32.3%) and haematological manifestations (27.1%). The rate of disease evolution of our cohort from a diagnosis of UCTD to a diagnosis of definite CTD was 12% within a mean time of 5.3 ± 2.8 years. With a total follow-up after first pregnancy of 1417 patient-years, we observed the evolution to a defined CTD in one out of every 88 patient- years.<BR>In our multicentre cohort, women with UCTD had a live birth rate of 79%. Women with UCTD should be referred to specialist follow-up when planning a pregnancy. ENA profiling and aPL testing should be mandatory in this setting, and further therapeutic approaches and management should be planned accordingly.