Pregnancy outcomes in women with primary Sjögren's syndrome: an analysis of data from the multicentre, prospective, GR2 study
- Type de publi. : Article dans une revue
- Date de publi. : 01/06/2023
-
Auteurs :
Grégoire Martin de FrémontNathalie Costedoat-ChalumeauEstibaliz LazaroRakiba BelkhirGaëlle Guettrot-ImbertNathalie MorelGaétane NocturneAnna MoltoTiphaine GoulenokElisabeth DiotLaurent PerardNicole Ferreira-MaldentMaelle Le BesneraisNicolas LimalNihal MartisNoémie AbisrorOdile Souchaud-DebouverieChristophe RichezVincent SobanskiFrançois MaurierGaëtan SauvetreHervé LevesqueMarie-Agnès TimsitNathalie TieuliéPauline OrquevauxBoris BienvenuMatthieu MahevasThomas PapoCéline Lartigau-RoussinElodie ChauvetEmilie BerthouxFrançoise Sarrot-ReynauldLoïc RaffrayMarion CoudercNicolas Martin SilvaNoémie Jourde-ChicheNicolas BelhommeThierry ThomasVincent PoindronViviane Queyrel-MoranneJuliette DelforgeCamille Le RayEmmanuelle PannierXavier MarietteVéronique Le GuernRaphaèle SerorAlexandra Audemard-VergerEmmanuel AzziBéatrice BannevilleAntoine BaudetConstance Beaudouin BazireCristina BeliznaAlexandre BelotYgal BenhamouAlice BereznéFanny Bernard-GuervillySabine BerthierHoly BezanaharyLisa BialeAdrien BigotClaire Blanchard-DelaunayAnne CalasJulien CampagnePascal CathebrasClaire CazaletsBenjamin ChaigneOlivia ChandesrisJérémy ChatelaisEmmanuel ChatelusFleur CohenBernard CombeCéline ComparonPascal CoquerelleLouise DamianEric DaugasMathilde de MenthonClaire de MoreuilEstelle DelattreAzeddine DellalCatherine Deneux-TharauxAmélie DenisCamille DeprouwEmmanuelle DernisAlban DerouxSandra DesouchesPhilippe DieudéGuillaume DirezMaxime DougadosMarine DriessenAurélie Du ThanhLaetitia DunogeantCécile DurantCécile-Audrey DurelIsabelle DurieuFlorence EboueElisabeth ElefantOlivier FainBruno FautrelRené-Marc FlipoAline FrazierAntoine FroissartSophie Georgin-LavialleElisabeth GervaisBertrand GodeauFrançois GoffinetAnne GompelLaure GossecPhilippe GoupilleClaire GrangeConstance Guillaud-DanisEric HachullaSabine HoefslootAurélie HummelPatrick JegoStéphanie JobardLaurence Josselin-MahrMarc LambertVincent LangloisDelphine LariviereClaire LarrocheAugustin LatourteChristian LavigneThomas Le GallouGaëlle LerouxJean Guillaume LetarouillyFrédéric LiotéLaurence LoeuilletJonathan LondonValentine LoustauPierre Lozac'HEmmanuel MaheuHélène MaillardHubert MarotteAgathe MasseauArsène MekinianSara Melboucy BelkhirCorinne Miceli-RichardMartin MichaudMarc MichelOlivier MoranneChafika Morati-HafsaouiGuillaume MoulisLuc MouthonBarbara NicolasJacky NizardJérémy OraRodérau OuthElisabeth PasquierJean-Loup PennaforteAntoinette PerlatHélène Petit-BauerEvangeline PilleboutJean-Maxime PiotAgnès PortierOlivier PourratXavier PuechalGregory PugnetManon RedondinAlexis RegentMélanie RorizLaurent SaillerLéa SaveyMarc ScherlingerNicolas SchleinitzJérémie SellamLoïc SentilhesAude ServaisPerrine SmetsChristelle SordetMartin SoubrierKatia Stankovic-StojanovicGeoffrey UrbanskiVéronique VeitEmmanuelle WeberCécile Yelnik
-
Organismes :
Hôpital Cochin [AP-HP]
Centre Hospitalier Universitaire de Bordeaux
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Service de Pharmacologie et Immunoanalyse
Centre de recherche en Immunologie des Infections virales et des maladies auto-immunes
Clinical Epidemiology Applied to Osteoarticular Diseases | Épidémiologie clinique appliquée aux maladies rhumatismales et musculo-squelettiques
Assistance publique - Hôpitaux de Paris (AP-HP)
Centre Hospitalier Régional Universitaire de Tours
Centre hospitalier Saint Joseph - Saint Luc [Lyon]
CHU Trousseau [Tours]
Physiopathologie, Autoimmunité, maladies Neuromusculaires et THErapies Régénératrices
Hôpital Henri Mondor
CHU Nice [Cimiez]
CHU Saint-Antoine [AP-HP]
Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle
Institute for Translational Research in Inflammation - U 1286
Hôpitaux Privés de Metz
Epidémiologie des Maladies Chroniques en zone tropicale
CHU Limoges
Santé Ingénierie Biologie Saint-Etienne
- Publié dans The Lancet Rheumatology le 13/12/2019
Résumé : Background Adverse pregnancy outcomes in women with primary Sjogren's syndrome have only been evaluated retrospectively using heterogeneous methods and with contradictory results. We aimed to describe adverse pregnancy, delivery, and birth outcome risks in pregnant women with primary Sjogren's syndrome compared with those of a matched general population in France, and to identify factors predictive of disease flares or adverse pregnancy outcomes. Methods We conducted a multicentre, prospective, cohort study in France using the GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) registry. Women from the GR2 study were eligible if they had conceived before March, 2021, had primary Sjogren's syndrome according to the American College of Rheumatology and European Alliance of Associations for Rheumatology (EULAR) 2016 classification criteria, and had an ongoing pregnancy at 12 weeks of gestation. In women who entered in the registry with pregnancies before 18 weeks of gestation, we sought to identify factors associated with primary Sjogren's syndrome flare (=3-point increase in EULAR Sjogren's Syndrome Disease Activity Index [ESSDAI] score) or adverse pregnancy outcomes (fetal or neonatal death, placental insufficiency leading to a preterm delivery [<37 weeks of gestation], or small-for-gestational-age birthweight). A matched controlled study compared adverse pregnancy, delivery, and birth outcome rates between pregnant women with primary Sjogren's syndrome from the GR2 registry and matched controls from the general population included in the last French perinatal survey (Enquete Nationale Perinatale 2016). Findings 1944 pregnancies were identified in the GR2 cohort, of which 106 pregnancies in 96 women with primary Sjogren's syndrome were included in this analysis. The median age at pregnancy onset was 33 years (IQR 31-36). 87 (83%) of 105 pregnancies (with ethnicity data) were in White women, 18 (17%) were in Black women; 92 (90%) of 102 had previous systemic activity (ESSDAI score of =1; data missing in four pregnancies), and 48 (45%) of 106 had systemic activity at inclusion. Of 93 pregnancies included at week 18 of gestation or earlier, primary Sjogren's syndrome flares occurred in 12 (13%). No baseline parameters were associated with primary Sjogren's syndrome flare. Four twin pregnancies and one medical termination were excluded from the adverse pregnancy outcome analysis; of the remaining 88, adverse pregnancy outcomes occurred in six (7%). Among pregnancies in women with data for antiphospholipid antibodies (n=55), antiphospholipid antibody positivity was more frequent among pregnancies with adverse outcomes (two [50%] of four pregnancies) compared with those without adverse outcomes (two [ 4%] of 51 pregnancies; p=0 center dot 023). Anti-RNP antibody positivity was also more frequent among pregnancies with adverse outcomes than those without, although this was not statistically significant. In the matched controlled study, adverse pregnancy outcomes occurred in nine (9%) of 105 pregnancies in women with primary Sjogren's syndrome and 28 (7%) of the 420 matched control pregnancies; adverse pregnancy outcomes were not significantly associated with primary Sjogren's syndrome (odds ratio 1 center dot 31, 95% CI 0 center dot 53-2 center dot 98; p=0 center dot 52). Interpretation Pregnancies in women with primary Sjogren's syndrome had very good prognoses for mothers and fetuses, with no overall increase in adverse pregnancy outcome risk compared with the general population. Women with antiphospholipid antibodies or anti-RNP antibodies require close monitoring, because these factors might be associated with a higher risk of adverse pregnancy outcomes. Funding Lupus France, Association des Sclerodermiques de France, Association Gougerot Sjogren, Association Francophone Contre la Polychondrite Chronique Atrophiante, AFM-Telethon, Societe Nationale Francaise de Medecine Interne, Societe Francaise de Rhumatologie, Cochin Hospital, French Health Ministry, Fondation for Research in Rheumatology, Association Prix Veronique Roualet, Union Chimique Belge.
Source