Melody P Chung1, Kathleen D Kolstad2, Makdine Dontsi3, Debbie Postlethwaite3, Poonam Manwani4, Hongyu Zhao4, Sumana Kesh4, Julia F Simard2, Lorinda Chung5. 1. Kaiser Permanente Santa Clara, Santa Clara, California, and Stanford University School of Medicine, Stanford, California, USA. 2. Stanford University School of Medicine, Stanford, California, USA. 3. Kaiser Permanente Northern California, Oakland, California, USA. 4. Kaiser Permanente Santa Clara, Santa Clara, California, USA. 5. Stanford University School of Medicine, Stanford, California, and VA Palo Alto Health Care System, Palo Alto, California, USA.
Abstract
OBJECTIVE: To investigate whether obstetric complications prior to systemic sclerosis (SSc) diagnosis are more common in SSc patients compared to the general obstetric population. METHODS: A case-control study was performed at Kaiser Permanente Northern California to compare prior obstetric complications in adult women who later developed SSc (cases) with women from the general obstetric population who did not develop SSc (controls; matched 10:1 by age and year of delivery) from 2007 to 2016. Exposures included past hypertensive disorders of pregnancy (preeclampsia, eclampsia, gestational hypertension), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), maternal infections, neonatal intensive care unit (NICU) admission, and preterm birth. Fischer's exact tests were used to compare categorical variables. Conditional logistic regression models estimated the odds ratio (OR), and corresponding 95% confidence intervals (95% CIs) for the outcome SSc. RESULTS: Seventeen SSc cases and 170 non-SSc controls were identified, with median maternal age at delivery 34 years (range 23-46 years) and median time from delivery to SSc diagnosis 2 years (range 0.2-7.3 years). Women with SSc were more likely to be Hispanic and Black. Prior obstetric complications appeared higher in women with an eventual SSc diagnosis compared to controls (70.6% versus 50%), including hypertensive disorders (17.7% versus 9.4%), PROM (11.8% versus 4.1%), IUGR (5.9% versus 1.8%), maternal infection (29.4% versus 14.1%), NICU admissions (23.5% versus 7.7%), and preterm delivery (29.4% versus 21.8%). Women with SSc had a higher odds of delivering infants requiring NICU admission (OR 4.7 [95% CI 1.2-18.8]). CONCLUSION: Women who eventually develop SSc had trends toward more complicated pregnancy histories before overt diagnosis.
OBJECTIVE: To investigate whether obstetric complications prior to systemic sclerosis (SSc) diagnosis are more common in SSc patients compared to the general obstetric population. METHODS: A case-control study was performed at Kaiser Permanente Northern California to compare prior obstetric complications in adult women who later developed SSc (cases) with women from the general obstetric population who did not develop SSc (controls; matched 10:1 by age and year of delivery) from 2007 to 2016. Exposures included past hypertensive disorders of pregnancy (preeclampsia, eclampsia, gestational hypertension), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), maternal infections, neonatal intensive care unit (NICU) admission, and preterm birth. Fischer's exact tests were used to compare categorical variables. Conditional logistic regression models estimated the odds ratio (OR), and corresponding 95% confidence intervals (95% CIs) for the outcome SSc. RESULTS: Seventeen SSc cases and 170 non-SSc controls were identified, with median maternal age at delivery 34 years (range 23-46 years) and median time from delivery to SSc diagnosis 2 years (range 0.2-7.3 years). Women with SSc were more likely to be Hispanic and Black. Prior obstetric complications appeared higher in women with an eventual SSc diagnosis compared to controls (70.6% versus 50%), including hypertensive disorders (17.7% versus 9.4%), PROM (11.8% versus 4.1%), IUGR (5.9% versus 1.8%), maternal infection (29.4% versus 14.1%), NICU admissions (23.5% versus 7.7%), and preterm delivery (29.4% versus 21.8%). Women with SSc had a higher odds of delivering infants requiring NICU admission (OR 4.7 [95% CI 1.2-18.8]). CONCLUSION: Women who eventually develop SSc had trends toward more complicated pregnancy histories before overt diagnosis.
Authors: Jelena Blagojevic; Khitam Abdullah AlOdhaibi; Aly M Aly; Silvia Bellando-Randone; Gemma Lepri; Cosimo Bruni; Alberto Moggi-Pignone; Serena Guiducci; Federico Mecacci; Marco Matucci-Cerinic; Daniel E Furst Journal: J Rheumatol Date: 2019-09-01 Impact factor: 4.666
Authors: J L Nelson; D E Furst; S Maloney; T Gooley; P C Evans; A Smith; M A Bean; C Ober; D W Bianchi Journal: Lancet Date: 1998-02-21 Impact factor: 79.321
Authors: Nathalie C Lambert; Y M Dennis Lo; Timothy D Erickson; Tracy S Tylee; Katherine A Guthrie; Daniel E Furst; J Lee Nelson Journal: Blood Date: 2002-10-15 Impact factor: 22.113
Authors: Linda van Wyk; Jacolien van der Marel; Annemie J M Schuerwegh; Anne A Schouffoer; Alexandre E Voskuyl; Tom W J Huizinga; Diana W Bianchi; Sicco A Scherjon Journal: Arthritis Res Ther Date: 2011-11-04 Impact factor: 5.156
Authors: Elizabeth V Arkema; Kristin Palmsten; Christopher Sjöwall; Elisabet Svenungsson; Jane E Salmon; Julia F Simard Journal: Arthritis Care Res (Hoboken) Date: 2016-07 Impact factor: 4.794