P81 15 years experience in follow-up of pregnancy of autoimmune diseases in a multidisciplinary unit. (23rd March 2020)

• Record Type: Journal Article
• Authors: Ruiz-Lucea, Esther; Ibarguengoitia, Oihane; Rivera, Natalia; Oraa, Jenaro; Úcar, Eduardo; Intxaurbe, Ana; Calvo, Itziar; Montero, David; Vega, Lucia; García, Carmen; Perez, Clara; Fernández, Olaia; Torre, Ignacio; Blanco, Juan; Galindez, Eva; Allande, MJ; Gorostiza, Iñigo; Cuende, Eduardo; García, Maria Luz
• Is Part Of: Lupus science & medicine. Volume 7(2020)Supplement 1
• Page Start: A68
• Page End: A69
• Publication Date: 2020-03-23
• Subjects: Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1136/lupus-2020-eurolupus.126
• Languages: English
• ISSNs: 2398-8851

Abstract

Abstract : Background: Women with autoimmune diseases have high-risk pregnancies. Close and multidisciplinary control is recommended. Objective: To describe the experience in a multidisciplinary unit (Rheumatologists and Obstetrics), assess complications and treatments in the evolution of pregnancies in patients with autoimmune diseases in a tertiary hospital. Material and Methods: Retrospective study of pregnancy outcomes in patients with autoimmune diseases and follow-up in a multidisciplinary unit between January 2003-December 2018. Demographics, maternal disease, previous abortions, autoantibodies (AAb), births and abortions during follow-up, treatment and maternal and fetal complications were collected. Data analysed using SPSS v23. Results: 109 patients (151 pregnancies). Maternal age at diagnosis: 34, 9 years; age at abortion/childbirth 38, 6 years. 50 abortions registered prior to follow-up in our unit (0.45 abortions/mother). During follow-up 19 abortions were registered (0.17 abortions/mother) (table 1 ). Abortions were more frequent among women with positive antiphospholipid antibodies (aPL) (14.3% vs 4.3%) (p =0, 013). Anti-Ro carriers (36.6%) didn't have higher frequency of abortions (p =0, 798); one case of heart block was recorded. 13.5% pre-term (<37 weeks) pregnancies; caesarean section (C-section) performed in 26% (17, 3% in SLE). Intrauterine growth restriction (IUGR) observed in 6 (3, 9%); pre-eclampsia in 4 (2, 6%): SLE (n:3 and n:2 respectively), APS (n:1 and n:1), anti-Ro carriers (n:2 and n:1). No difference in complications between anti-Ro positive and negative women (p =0.047). Hydroxicloroquine prescribed in 97 patients (64%), aspirin in 99 (65, 6%), heparin in 33 (21, 9%) and prednisone in 48 (31%). Conclusions: In our series, women with SLE and APL have higher risk of abortion, pregnancy complications and instrumental delivery than general population. Anti-Ro carriers don't have increased rate of abortions nor complications during pregnancy. Follow-up of pregnancy in a multidisciplinary unit decreases the risk of abortion.