#2-36E. SSc and Pregnancy: High Risks, Especially for First-Time Mothers (Arthritis Rheum, 2025)

Managing pregnancy in women with systemic sclerosis (SSc) presents unique challenges. How significant are the risks of adverse pregnancy outcomes (APOs), and how should we tailor our management for this vulnerable group? This Swedish population-based cohort study assembled pregnancies between 1998 and 2021 to assess APO risks relative to SSc diagnosis timing and parity. The study concluded that pregnancies occurring after an SSc diagnosis exhibited markedly increased risks for preeclampsia, preterm birth (PTB), and cesarean delivery compared to the general population. Furthermore, increased APO risks were observed even in pregnancies occurring up to three years before an SSc diagnosis, suggesting a preclinical impact. The most critical clinical finding is that the risk of APOs—specifically preeclampsia (Adjusted RR 7.5) and PTB (Adjusted RR 5.1)—was substantially higher among primiparous women following an SSc diagnosis. This pinpoints a specific high-risk subgroup, emphasizing the need for focused care. However, a limitation of this registry-based design is the lack of clinical data on SSc disease activity and specific treatments, such as the use of low-dose acetylsalicylic acid (LDASA), which could influence outcomes. These results underscore the critical importance of specialized, multidisciplinary maternal care and prepregnancy counseling for SSc patients, especially those anticipating their first birth.

Citation: Weng Ian Che, et al. Pregnancy Outcomes in Women With Systemic Sclerosis Before and/or After Diagnosis and by Parity: A Swedish Population-Based Cohort Study. Arthritis & Rheumatology. 2025. DOI: 10.1002/art.43312

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