AB0830 ADVERSE PERINATAL OUTCOMES AND CONGENITAL DEFECTS IN MEXICAN WOMEN WITH AUTOIMMUNE RHEUMATIC DISEASES
Authors: R. A. Rodriguez Chavez, C. M. Skinner Taylor, L. Pérez Barbosa, G. A. López-Uriarte, E. Barriga-Maldonado, G. Figueroa-Parra, I. Perez-Onofre, A. Elizondo-Plazas, L. G. Espinosa Banuelos, R. Moyeda Martinez, A. Y. Lujano Negrete, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2021)

Background: Pregnancy in women with autoimmune rheumatic diseases (ARD) is associated with an increase in the risk of adverse perinatal outcomes and birth defects. Many factors have been attributed to these including medication employed and maternal autoantibodies. The national prevalence of congenital anomalies in newborns in Mexico is estimated to be 73.9 per 10,000 births but the rate of these in Mexican women with ARD is unknown. Objectives: This study aims to describe the frequency of adverse perinatal outcomes and congenital defects in Mexican women with ARD. Methods: We performed a descriptive and prospective study that included all pregnant patients with ARDs from the clinic of pregnancy and rheumatic diseases in the University Hospital “Dr. José Eleuterio González” who gave birth between February 2019 to November 2020. Demographic information, pregnancy outcome, and congenital defects were prospectively evaluated. Congenital defects were clinically confirmed by a clinical geneticist. Results: A total of 40 women were taken in the final analyses. The ARD diagnosis is shown in graphic 1. Rheumatoid arthritis was the most frequent diagnosis that had an adverse perinatal outcome with 4 (40%) and congenital defects in 2 (40%). No complications or birth defects were reported in 25 (62.5%). The adverse perinatal outcome was reported in 10 (25%) women and congenital defects in 5 (12.5%). The most frequent adverse perinatal outcomes were preterm birth 6 (15%) and the second most frequent miscarriage 3 (7.5%) (Table 1 below). Conclusion: We found a high frequency (12.5%) of adverse perinatal outcomes and congenital defects in Mexican women with ARD. Multidisciplinary groups and clinics are needed to adequately serve this complex population and reduce morbidity and mortality. A multidisciplinary approach before, during, and after pregnancy in patients with ARD may improve morbidity and mortality. References: [1]Vinet, E., Bernatsky, S. (2017). Outcomes in Children Born to Women with Rheumatic Diseases. Rheum Dis Clin N Am. http://dx.doi.org/10.1016/j.rdc.2016.12.006 . [2]Krishnan AN, Sable CA, Donofrio MT.(2008). Spectrum of fetal echocardiographic findings in fetuses of women with clinical or serologic evidence of systemic lupus erythematosus. J Matern Fetal Neonatal Med. 21(11):776–82. [3]NAVARRETE HERNANDEZ, Eduardo et al. Prevalencia de malformaciones congénitas registradas en el certificado de nacimiento y de muerte fetal: México, 2009-2010. Bol. Med. Hosp. Infant. Mex. [online]. 2013, vol.70, n.6, pp.499-505. Graphic 1. Percentage of adverse perinatal outcomes and congenital defects due to rheumatic disease. Table 1. Frequency and percentages of adverse perinatal outcomes and congenital defects. Adverse perinatal outcome (n=10) 25% Congenital defects (n=5) 12.5% Preterm birth 6 (15%) - Miscarriage 3 (7.5%) - Stillbirth 1 (2.5%) - Congenital heart disease* - 1 (2.5%) Congenital cardiac block with pacemaker placement - 1 (2.5%) Krabbe´s disease - 1 (2.5%) Preauricular appendix - 1 (2.5%) Diabetic fetopathy - 1 (2.5%) *Tetralogy of Fallot Disclosure of Interests: None declared