Abstract
Sjogren’s syndrome (SS), mixed connective tissue disease (MCTD), and undifferentiated connective tissue disease (UCTD) are less common disorders than systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA), but like SLE and RA, these disorders have a higher incidence in women. Sjogren’s syndrome predominately impacts women in their later reproductive years. Because of the older age distribution in Sjogren’s and the relative rarity of MCTD and UCTD, there is little published information on pregnancy outcome or on impact of pregnancy on maternal disease.
In general, these disorders appear to have minimal adverse effects on patients’ reproductive potential. Fertility is maintained. Although those with increased disease activity in MCTD are at higher risk for certain pregnancy complications, patients whose disease is under control at conception generally do well. Pregnancy does not appear to contribute to disease activity in Sjogren’s or MCTD. Based on limited data, pregnancy may cause patients with UCTD to evolve into more classical connective tissue disorders such as RA or SLE: this low but finite risk should be discussed. The general approach used in the management of other pregnant rheumatic disease patients should be utilized for these patients: pregnancies should be planned, disease activity should be minimized for 6 months prior to pregnancy, and patients should be well controlled on medications compatible with pregnancy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Mosca M, Neri R, Strigini F, Carmignani A, Totti D, Tavoni A, Bombardieri S. Pregnancy outcome in patients with undifferentiated connective tissue disease: a preliminary study on 25 pregnancies. Lupus. 2002;11:304–7.
Steele JC, Dawson LJ, Moots RJ, Field EA. Congenital heart block associated with undiagnosed maternal primary Sjogren’s syndrome – a case report and discussion. Oral Dis. 2005;11:190–2.
Amigues JM, Cantagrel A, Abbal M, Mazieres B. Comparative study of 4 diagnosis criteria sets for mixed connective tissue disease in patients with anti-RNP antibodies. Autoimmunity group of the Hospitals of Toulouse. J Rheumatol. 1996;23:2055–62.
Mosca M, Tani C, Carli L, Bombardieri S. Undifferentiated CTD: a wide spectrum of autoimmune diseases. Best Pract Res Clin Rheumatol. 2012;26:73–7.
Danieli MG, Fraticelli P, Franceschini F, Cattaneo R, Farsi A, Passaleva A, Pietrogrande M, Invernizzi F, Vanoli M, Scorza R, Sabbadini MG, Gerli R, Corvetta A, Farina G, Salsano F, Priori R, Valesini G, Danieli G. Five-year follow-up of 165 Italian patients with undifferentiated connective tissue diseases. Clin Exp Rheumatol. 1999;17:585–91.
Bodolay E, Csiki Z, Szekanecz Z, Ben T, Kiss E, Zeher M, Szucs G, Danko K, Szegedi G. Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD). Clin Exp Rheumatol. 2003;21:313–20.
Skopouli FN, Papanikolaou S, Malamou-Mitsi V, Papanikolaou N, Moutsopoulos HM. Obstetric and gynaecological profile in patients with primary Sjogren’s syndrome. Ann Rheum Dis. 1994;53:569–73.
Belenguer R, Ramos-Casals M, Brito-Zeron P, del Pino J, Sentis J, Aguilo S, Font J. Influence of clinical and immunological parameters on the health-related quality of life of patients with primary Sjogren’s syndrome. Clin Exp Rheumatol. 2005;23:351–6.
Siamopoulou-Mavridou A, Manoussakis MN, Mavridis AK, Moutsopoulos HM. Outcome of pregnancy in patients with autoimmune rheumatic disease before the disease onset. Ann Rheum Dis. 1988;47:982–7.
Julkunen H, Kaaja R, Kurki P, Palosuo T, Friman C. Fetal outcome in women with primary Sjogren’s syndrome. A retrospective case-control study. Clin Exp Rheumatol. 1995;13:65–71.
Takaya M, Ichikawa Y, Shimizu H, Uchiyama M, Moriuchi J, Arimori S. Sjogren’s syndrome and pregnancy. Tokai J Exp Clin Med. 1991;16:83–8.
Hussein SZ, Jacobsson LT, Lindquist PG, Theander E. Pregnancy and fetal outcome in women with primary Sjogren’s syndrome compared with women in the general population: a nested case-control study. Rheumatology (Oxford). 2011;50:1612–7.
Haga HJ, Gjesdal CG, Koksvik HS, Skomsvoll JF, Irgens LM, Ostensen M. Pregnancy outcome in patients with primary Sjogren’s syndrome. A case-control study. J Rheumatol. 2005;32:1734–6.
Brucato A, Doria A, Frassi M, Castellino G, Franceschini F, Faden D, Pisoni MP, Solerte L, Muscara M, Lojacono A, Motta M, Cavazzana I, Ghirardello A, Vescovi F, Tombini V, Cimaz R, Gambari PF, Meroni PL, Canesi B, Tincani A. Pregnancy outcome in 100 women with autoimmune diseases and anti-Ro/SSA antibodies: a prospective controlled study. Lupus. 2002;11:716–21.
Kitridou RC. Pregnancy in mixed connective tissue disease. Rheum Dis Clin North Am. 2005;31:497–508, vii.
Lundberg I, Hedfors E. Pregnancy outcome in patients with high titer anti-rnp antibodies. A retrospective study of 40 pregnancies. J Rheumatol. 1991;18:359–62.
Nayak SS, Adiga PK, Rai L, Girisha KM. Severe rhizomelic chondrodysplasia punctata in a fetus due to maternal mixed connective tissue disorder. Genet Couns. 2012;23:487–91.
Schulz SW, Bober M, Johnson C, Braverman N, Jimenez SA. Maternal mixed connective tissue disease and offspring with chondrodysplasia punctata. Semin Arthritis Rheum. 2010;39:410–6.
Castellino G, Capucci R, Bernardi S, Padovan M, Giacuzzo S, Pivato E, Patella A, Trotta F, Govoni M. Pregnancy in patients with undifferentiated connective tissue disease: a prospective case-control study. Lupus. 2011;20:1305–11.
Spinillo A, Beneventi F, Ramoni V, Caporali R, Locatelli E, Simonetta M, Cavagnoli C, Alpini C, Albonico G, Prisco E, Montecucco C. Prevalence and significance of previously undiagnosed rheumatic diseases in pregnancy. Ann Rheum Dis. 2012;71:918–23.
Spinillo A, Beneventi F, Epis OM, Montanari L, Mammoliti D, Ramoni V, Di Silverio E, Alpini C, Caporali R, Montecucco C. The effect of newly diagnosed undifferentiated connective tissue disease on pregnancy outcome. Am J Obstet Gynecol. 2008;199:632, e631–6.
Beneventi F, Locatelli E, Ramoni V, Caporali R, Montecucco CM, Simonetta M, Cavagnoli C, Ferrari M, Spinillo A. Uterine artery Doppler velocimetry and obstetric outcomes in connective tissue diseases diagnosed during the first trimester of pregnancy. Prenat Diagn. 2012;32: 1094–101.
Aslan E, Tarim E, Kilicdag E, Simsek E. Sjogren’s syndrome diagnosed in pregnancy: a case report. J Reprod Med. 2005;50:67–70.
Mutsukura K, Nakamura H, Iwanaga N, Ida H, Kawakami A, Origuchi T, Furuyama M, Eguchi K. Successful treatment of a patient with primary Sjogren’s syndrome complicated with pericarditis during pregnancy. Intern Med. 2007;46:1143–7.
Yamaguchi T, Ohshima S, Tanaka T, Tsukada S, Matsushita M, Kohmo S, Kanzaki T, Saeki Y. Renal crisis due to intimal hyperplasia in a patient with mixed connective tissue disease (MCTD) accompanied by pulmonary hypertension. Intern Med. 2001;40:1250–3.
Watanabe R, Tatsumi K, Uchiyama T, Kato K, Okada O, Nagao K, Kuriyama T. Puerperal secondary pulmonary hypertension in a patient with mixed connective tissue disease. Nihon Kyobu Shikkan Gakkai Zasshi. 1995;33:883–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media New York
About this chapter
Cite this chapter
Bermas, B.L., Sammaritano, L.R. (2014). Pregnancy in Sjogren’s Syndrome, Mixed Connective Tissue Disease, and Undifferentiated Connective Tissue Disease. In: Sammaritano, L., Bermas, B. (eds) Contraception and Pregnancy in Patients with Rheumatic Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0673-4_5
Download citation
DOI: https://doi.org/10.1007/978-1-4939-0673-4_5
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-0672-7
Online ISBN: 978-1-4939-0673-4
eBook Packages: MedicineMedicine (R0)