AB0828 RISK FACTORS ANALYSIS OF SJOGREN’S SYNDROME COMBINED WITH PREGNANCY A MULTICENTER RETROSPECTIVE STUDY
Authors: Z. Tan, M. Shao, Y. Zhou, L. Wang, Y. MA, N. Xiang, X. Yuan, B. Wang, X. Xie, M. Zhou, Y. Wang, S. LI, X. LI
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In the current scenario, the population issue is becoming increasingly severe, prompting greater attention to pregnancy. It is well-known that during pregnancy, the maternal immune system must tolerate the semi-allogeneic fetus. This situation, when occurring in autoimmune diseases, may trigger disease relapse. Another previous meta-analysis demonstrated that the dynamic changes in pregnancy risks for women with autoimmune diseases depend on factors such as maternal disease activity, organ damage, autoantibody titers, and therapeutic interventions [1]. A recent prospective study in France revealed different results: compared to the general population, women with pSS do not exhibit an increased risk of adverse pregnancy outcomes, even in the case of active pSS. However, women with anti-phospholipid antibodies or anti-RNP antibodies should be closely monitored[2]. Therefore, a nuanced understanding of the association between pSS and pregnancy becomes particularly crucial. <h3>Objectives:</h3> Increased risk of adverse gestational outcomes in pregnant women with primary Sjögren's syndrome. <h3>Methods:</h3> This study aimed to identify risk factors contributing to diverse pregnancy outcomes in primary Sjögren's syndrome(pSS) cases. <h3>Results:</h3> This study included 164 pregnant women with pSS and 328 control subjects, with no statistically significant difference in average age between the two groups. Analysis of pregnancy outcomes revealed that, compared to the control group, pregnant women in the pSS group were more likely to experience miscarriages, both spontaneous (12.80% vs. 1.52%, P&lt;0.001) and therapeutic (6.10% vs. 0.91%, P&lt;0.05). The proportion of placental abnormalities detected during prenatal ultrasound in women from the pSS group was higher (14.63% vs. 6.40%, P&lt;0.05). In the analysis of pregnancy outcomes for live-born neonates, a higher incidence of congenital heart abnormalities was observed in the pSS group (27.34% vs. 12.03%, P&lt;0.05). While there were no significant differences between the pSS pregnancies in terms of both normal and adverse pregnancy outcomes, a comparison of fetal survival and fetal loss in pSS pregnancies revealed a greater use of prophylactic anticoagulant therapy in the fetal survival group. Notably, the application of low molecular weight heparin(LMWH) emerged as an independent protective factor for fetal survival. <h3>Conclusion:</h3> Compared to non-autoimmune controls, pregnancy in women with pSS presents more challenges. Importantly, we observed that the use of LMWH as anticoagulant therapy is an independent protective measure for fetal survival. <h3>REFERENCES:</h3> [1] Carvalheiras G, Faria R, Braga J, Vasconcelos C. Fetal outcome in autoimmune diseases. Autoimmun Rev. 2012;11(6-7):A520-A530. doi:10.1016/j.autrev.2011.12.002. [2] Grégoire Martin de Frémont, et al. Pregnancy outcomes in women with primary Sjögren's syndrome: an analysis of data from the multicentre, prospective, GR2 study. The Lancet Rheumatology. 2023;5(6): E330-E340. DOI: https://doi.org/10.1016/S2665-9913(23)00099-1 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>