Primary Sjögren's syndrome and pregnancy: A report of 18 cases

Abstract

Primary Sjögren's syndrome (pSS) is a condition that predominantly affects women. Reports of pregnancy outcome in these patients are limited and contradictory.

Objective: To describe pregnancy characteristics and outcomes and newborn morbidity in women with pSS.

Material and methods: We included women with pSS who became pregnant after the onset of the symptoms of the disease. Clinical and serological characteristics, risk factors and previous maternal comorbidities are described. For each pregnancy in a woman with pSS, we recorded pregnancy course and outcome and newborn condition.

Results: We assessed 11 patients with 18 pregnancies after the onset of pSS symptoms. All of them presented FAN +; 10 anti-Ro / SSA + and 7 anti-La / SSB +. The mean age in years at the onset of symptoms was 24.9 (SD 6.9) and at the time of pregnancy was 30.3 (SD 5.4). Thirteen pregnancies happened before the diagnosis, reporting only one miscarriage. Two preterm births, 1 case of oligohydramnios, 2 of premature membrane rupture and 2 low birthweight babies were reported after the onset of pSS symptoms. There was 1 newborn with congenital atrioventricular block and another with neonatal cutaneous lupus. All the women with pregnancy complications (n=6) had anti-Ro/SSA antibodies.

Conclusions: Almost half of the pregnancies assessed in women with pSS were associated with complications not attributable to factors other than the disease.

Keywords: Bloqueo cardíaco congénito; Congenital heart block; Embarazo; Pregnancy; Sjögren's syndrome; Síndrome de Sjögren.