1. Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospective Italian P-RHEUM.it study
- Author
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Andreoli, L, Gerardi, M, Gerosa, M, Rozza, D, Crisafulli, F, Erra, R, Lini, D, Trespidi, L, Padovan, M, Ruffilli, F, Serale, F, Cuomo, G, Raffeiner, B, Semeraro, P, Tani, C, Chimenti, M, Conigliaro, P, Hoxha, A, Nalli, C, Fredi, M, Lazzaroni, M, Filippini, M, Taglietti, M, Franceschini, F, Zatti, S, Loardi, C, Orabona, R, Ramazzotto, F, Zanardini, C, Fontana, G, Gozzoli, G, Barison, C, Bizioli, P, Caporali, R, Carrea, G, Ossola, M, Maranini, B, Silvagni, E, Govoni, M, Morano, D, Verteramo, R, Doria, A, Del Ross, T, Favaro, M, Calligaro, A, Tonello, M, Larosa, M, Zen, M, Zambon, A, Mosca, M, Zucchi, D, Elefante, E, Gori, S, Iannone, F, Anelli, M, Lavista, M, Abbruzzese, A, Fasano, C, D'Angelo, S, Cutro, M, Picerno, V, Carbone, T, Padula, A, Rovere-Querini, P, Canti, V, De Lorenzo, R, Cavallo, L, Ramoni, V, Montecucco, C, Codullo, V, Milanesi, A, Pazzola, G, Comitini, G, Marvisi, C, Salvarani, C, Epis, O, Benedetti, S, Di Raimondo, G, Gagliardi, C, Lomater, C, Crepaldi, G, Bellis, E, Bellisai, F, Garcia Gonzalez, E, Pata, A, Zerbinati, M, Urban, M, Mattioli, I, Iuliano, A, Sebastiani, G, Brucato, A, Bizzi, E, Cutolo, M, Santo, L, Tonetta, S, Landolfi, G, Carrara, G, Bortoluzzi, A, Scirè, C, Tincani, A, Andreoli, Laura, Gerardi, Maria Chiara, Gerosa, Maria, Rozza, Davide, Crisafulli, Francesca, Erra, Roberta, Lini, Daniele, Trespidi, Laura, Padovan, Melissa, Ruffilli, Francesca, Serale, Francesca, Cuomo, Giovanna, Raffeiner, Bernd, Semeraro, Paolo, Tani, Chiara, Chimenti, Maria Sole, Conigliaro, Paola, Hoxha, Ariela, Nalli, Cecilia, Fredi, Micaela, Lazzaroni, Maria Grazia, Filippini, Matteo, Taglietti, Marco, Franceschini, Franco, Zatti, Sonia, Loardi, Chiara, Orabona, Rossana, Ramazzotto, Francesca, Zanardini, Cristina, Fontana, Giulia, Gozzoli, Giorgia, Barison, Claudia, Bizioli, Paola, Caporali, Roberto Felice, Carrea, Giulia, Ossola, Manuela Wally, Maranini, Beatrice, Silvagni, Ettore, Govoni, Marcello, Morano, Danila, Verteramo, Rosita, Doria, Andrea, Del Ross, Teresa, Favaro, Maria, Calligaro, Antonia, Tonello, Marta, Larosa, Maddalena, Zen, Margherita, Zambon, Alessandra, Mosca, Marta, Zucchi, Dina, Elefante, Elena, Gori, Sabrina, Iannone, Florenzo, Anelli, Maria Grazia, Lavista, Marlea, Abbruzzese, Anna, Fasano, Carlo Giuseppe, D'Angelo, Salvatore, Cutro, Maria Stefania, Picerno, Valentina, Carbone, Teresa, Padula, Angela Anna, Rovere-Querini, Patrizia, Canti, Valentina, De Lorenzo, Rebecca, Cavallo, Ludovica, Ramoni, Véronique, Montecucco, Carlomaurizio, Codullo, Veronica, Milanesi, Alessandra, Pazzola, Giulia, Comitini, Giuseppina, Marvisi, Chiara, Salvarani, Carlo, Epis, Oscar Massimiliano, Benedetti, Sara, Di Raimondo, Giuseppina, Gagliardi, Clizia, Lomater, Claudia, Crepaldi, Gloria, Bellis, Elisa, Bellisai, Francesca, Garcia Gonzalez, Estrella, Pata, Anna Paola, Zerbinati, Martina, Urban, Maria Letizia, Mattioli, Irene, Iuliano, Annamaria, Sebastiani, Giandomenico, Brucato, Antonio Luca, Bizzi, Emanuele, Cutolo, Maurizio, Santo, Leonardo, Tonetta, Sara, Landolfi, Gianpiero, Carrara, Greta, Bortoluzzi, Alessandra, Scirè, Carlo Alberto, Tincani, Angela, Andreoli, L, Gerardi, M, Gerosa, M, Rozza, D, Crisafulli, F, Erra, R, Lini, D, Trespidi, L, Padovan, M, Ruffilli, F, Serale, F, Cuomo, G, Raffeiner, B, Semeraro, P, Tani, C, Chimenti, M, Conigliaro, P, Hoxha, A, Nalli, C, Fredi, M, Lazzaroni, M, Filippini, M, Taglietti, M, Franceschini, F, Zatti, S, Loardi, C, Orabona, R, Ramazzotto, F, Zanardini, C, Fontana, G, Gozzoli, G, Barison, C, Bizioli, P, Caporali, R, Carrea, G, Ossola, M, Maranini, B, Silvagni, E, Govoni, M, Morano, D, Verteramo, R, Doria, A, Del Ross, T, Favaro, M, Calligaro, A, Tonello, M, Larosa, M, Zen, M, Zambon, A, Mosca, M, Zucchi, D, Elefante, E, Gori, S, Iannone, F, Anelli, M, Lavista, M, Abbruzzese, A, Fasano, C, D'Angelo, S, Cutro, M, Picerno, V, Carbone, T, Padula, A, Rovere-Querini, P, Canti, V, De Lorenzo, R, Cavallo, L, Ramoni, V, Montecucco, C, Codullo, V, Milanesi, A, Pazzola, G, Comitini, G, Marvisi, C, Salvarani, C, Epis, O, Benedetti, S, Di Raimondo, G, Gagliardi, C, Lomater, C, Crepaldi, G, Bellis, E, Bellisai, F, Garcia Gonzalez, E, Pata, A, Zerbinati, M, Urban, M, Mattioli, I, Iuliano, A, Sebastiani, G, Brucato, A, Bizzi, E, Cutolo, M, Santo, L, Tonetta, S, Landolfi, G, Carrara, G, Bortoluzzi, A, Scirè, C, Tincani, A, Andreoli, Laura, Gerardi, Maria Chiara, Gerosa, Maria, Rozza, Davide, Crisafulli, Francesca, Erra, Roberta, Lini, Daniele, Trespidi, Laura, Padovan, Melissa, Ruffilli, Francesca, Serale, Francesca, Cuomo, Giovanna, Raffeiner, Bernd, Semeraro, Paolo, Tani, Chiara, Chimenti, Maria Sole, Conigliaro, Paola, Hoxha, Ariela, Nalli, Cecilia, Fredi, Micaela, Lazzaroni, Maria Grazia, Filippini, Matteo, Taglietti, Marco, Franceschini, Franco, Zatti, Sonia, Loardi, Chiara, Orabona, Rossana, Ramazzotto, Francesca, Zanardini, Cristina, Fontana, Giulia, Gozzoli, Giorgia, Barison, Claudia, Bizioli, Paola, Caporali, Roberto Felice, Carrea, Giulia, Ossola, Manuela Wally, Maranini, Beatrice, Silvagni, Ettore, Govoni, Marcello, Morano, Danila, Verteramo, Rosita, Doria, Andrea, Del Ross, Teresa, Favaro, Maria, Calligaro, Antonia, Tonello, Marta, Larosa, Maddalena, Zen, Margherita, Zambon, Alessandra, Mosca, Marta, Zucchi, Dina, Elefante, Elena, Gori, Sabrina, Iannone, Florenzo, Anelli, Maria Grazia, Lavista, Marlea, Abbruzzese, Anna, Fasano, Carlo Giuseppe, D'Angelo, Salvatore, Cutro, Maria Stefania, Picerno, Valentina, Carbone, Teresa, Padula, Angela Anna, Rovere-Querini, Patrizia, Canti, Valentina, De Lorenzo, Rebecca, Cavallo, Ludovica, Ramoni, Véronique, Montecucco, Carlomaurizio, Codullo, Veronica, Milanesi, Alessandra, Pazzola, Giulia, Comitini, Giuseppina, Marvisi, Chiara, Salvarani, Carlo, Epis, Oscar Massimiliano, Benedetti, Sara, Di Raimondo, Giuseppina, Gagliardi, Clizia, Lomater, Claudia, Crepaldi, Gloria, Bellis, Elisa, Bellisai, Francesca, Garcia Gonzalez, Estrella, Pata, Anna Paola, Zerbinati, Martina, Urban, Maria Letizia, Mattioli, Irene, Iuliano, Annamaria, Sebastiani, Giandomenico, Brucato, Antonio Luca, Bizzi, Emanuele, Cutolo, Maurizio, Santo, Leonardo, Tonetta, Sara, Landolfi, Gianpiero, Carrara, Greta, Bortoluzzi, Alessandra, Scirè, Carlo Alberto, and Tincani, Angela
- Abstract
Objectives To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures.
- Published
- 2024