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Chung MP, Kolstad KD, Dontsi M, et al. Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis. Arthritis Care Res (Hoboken). 2020;doi: 10.1002/acr.24533.
Chung, M. P., Kolstad, K. D., Dontsi, M., Postlethwaite, D., Manwani, P., Zhao, H., Kesh, S., Simard, J. F., & Chung, L. (2020). Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis. Arthritis care & research, . https://doi.org/10.1002/acr.24533
Chung, Melody P, et al. "Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis." Arthritis care & research vol. (2020). doi: https://doi.org/10.1002/acr.24533
Chung MP, Kolstad KD, Dontsi M, Postlethwaite D, Manwani P, Zhao H, Kesh S, Simard JF, Chung L. Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis. Arthritis Care Res (Hoboken). 2020 Dec 08; doi: 10.1002/acr.24533. Epub 2020 Dec 08. PMID: 33290624; PMCID: PMC8184883.
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Arthritis Care Res (Hoboken). 2020 Dec 08; doi: 10.1002/acr.24533. Epub 2020 Dec 08.

Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis.

Arthritis care & research

Melody P Chung, Kathleen D Kolstad, Makdine Dontsi, Debbie Postlethwaite, Poonam Manwani, Hongyu Zhao, Sumana Kesh, Julia F Simard, Lorinda Chung

Affiliations

  1. Department of Internal Medicine, Kaiser Permanente Santa Clara, Santa Clara, CA, USA.
  2. Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA.
  3. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
  4. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
  5. Division of Immunology and Rheumatology, Palo Alto Health Care System, Palo Alto, CA, USA.

PMID: 33290624 PMCID: PMC8184883 DOI: 10.1002/acr.24533

Abstract

OBJECTIVE: To investigate whether obstetric complications prior to systemic sclerosis (SSc) diagnosis are more common 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 2007-2016. 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 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). SSc cases 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% vs. 50%), including hypertensive disorders (17.7% vs. 9.4%), PROM (11.8% vs. 4.1%), IUGR (5.9% vs 1.8%), maternal infection (29.4% vs. 14.1%), NICU admissions (23.5% vs. 7.7%), and preterm delivery (29.4% vs. 21.8%). Cases had a higher odds of delivering infants requiring NICU admission (OR=4.7, 95% CI 1.2-18.8).

CONCLUSIONS: Women who eventually develop SSc had trends towards more complicated pregnancy histories before overt diagnosis.

This article is protected by copyright. All rights reserved.

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