AB1218 MATERNAL-FETAL MORBIDITY AND MORTALITY AMONG PREGNANT PATIENTS WITH RHEUMATIC DISEASES IN THE CLINIC OF PREGNANCY AND ARTHRITIS OF THE SALVADORAN SOCIAL SECURITY INSTITUTE
Authors: R. I. López, R. Montufar, D. Alpizar-Rodriguez
Journal: Annals of the Rheumatic Diseases (2020)

Background: Connective tissue diseases are more frequent among women in childbearing age. In the past, it was not recommended for these women to get pregnant because of the risk of adverse pregnancy outcomes. Objectives: The aim of this study is to compare the morbidity and mortality between pregnant patients with rheumatic diseases and pregnant patients without rheumatic diseases in El Salvador. Methods: A case control study was conducted at the Clinic of Pregnancy and Arthritis and the 1° de Mayo Hospital , both centers belong to the Salvadoran Social Security Institute . Clinical files were reviewed retrospectively and some of the data were collected during the clinical visit to each center. We included pregnant patients with rheumatic diseases of the Clinic of Pregnancy and Arthritis; the control group was randomly selected with a ratio 1:1 within pregnant patients without rheumatic diseases of the 1° de Mayo Hospital, between January 2016 and June 2019. A complication was defined as any event that required hospital admission. We used logistic regression to analyze univariable and multivariable associations to compare pregnancy outcomes between groups. Results: During the study period, 230 patients were randomly included in both, the study group and the control group, with a ratio 1:1. The mean age for the study group was 32 (27-35) years, which was relatively older than the control group, 28 (24-32) years. The mean pregnancy among both groups was 2 per patient. The most common rheumatic diseases in the study group were Rheumatoid arthritis (39.1%), Antiphospholipid Syndrome (31.3%) and Generalized Lupus Erythematosus (20%). The average visit to the Rheumatologist during pregnancy in the study group was 3.2. The visits started at a mean of 15.2 + 7.6 weeks of gestational age. Thirty three point nine percent (33.9%) of the study group presented complications during pregnancy (vs 20.9%). Among the patients who presented complications, 9 of them (7.8%) had more than one complication during pregnancy. There were 44.3% cesarean deliveries in the study group compared with 22.6% in the control group, OR 2.1 (1.5-4.8) p=0.001. There were 16% of preterm deliveries between 34-37 weeks of gestational age in the study group compared to 10% in the control group, OR 2.2 (0.9-4.8) p=0.063. Preterm deliveries before 34 weeks of gestational age in the study group were 18% compared to 3% in the control group, OR 6.9 (2.3-20-9) p=0.001. There were 6 cases of spontaneous abortion in the study group and none in the control group. Thirty four percent (34%) of cases with low birth weight (&lt;2.5kg) were found in the study group compared to 14% in the control group, OR 3.4 (1.6-6.1) p=0.001. Conclusion: The most common rheumatic diseases among pregnant patients were Rheumatoid Arthritis, Antiphospholipid syndrome and Generalized Lupus Erythematosus. Having a rheumatic disease was more associated with cesarean delivery, preterm delivery between 34 and 37 weeks of gestational age, and low birth weight. References: [1]M. Gayed, C. Gordon. Pregnancy and rheumatic diseases. Rheumatology 2007;46:1634–1640. [2]Y A de Man, et al. Annals of Rheumatic Diseases. 2008. 10.1136 Disclosure of Interests: None declared