Preconception Obstetrics and Rheumatology Consultation: A Protective Factor Against Spontaneous Abortion in Women with Autoimmune Rheumatic Disorders

Background: Autoimmune rheumatic disorders are a group of illnesses that significantly affect pregnancy outcomes .Aim: To evaluate the association of maternal medical care, autoantibody profile, and medications with spontaneous abortion .Methods: In this cross-sectional study, we recruited patients who were referred to our clinic from September ۲۰۱۴ to September ۲۰۱۹. All confirmed pregnancies (based on a positive pregnancy test and sonogram) were included. Binary logistic regression was applied to construct the statistical model.Findings: The present study consists of ۱۰۲ women with ۲۲۷ confirmed pregnancies who were diagnosed with eight different autoimmune rheumatic disorders. The rate of spontaneous abortion was ۲۹.۱ percent. In the univariate analysis, the preconception obstetrics and rheumatology consultation were negatively correlated with spontaneous abortion (p-value: <۰.۰۰۱, OR (۹۵% CI): ۰.۲۸۹ (۰.۱۵۸-۰.۵۲۹) and p-value: <۰.۰۰۱, OR (۹۵% CI): ۰.۰۵۱ (۰.۰۲۰-۰.۱۳۵), respectively). Perinatal obstetric care had a significant protective effect, with p-value: <۰.۰۰۱ and OR (۹۵% CI) of ۰.۳۰۵ (۰.۱۶۸-۰.۵۵۴). The multivariate analysis showed that the preconception rheumatology consultation (p-value: ۰.۰۰۲, OR (۹۵% CI): ۰.۰۵۰ (۰.۰۰۷-۰.۳۴۴)) and preconception hydroxychloroquine usage (p-value: ۰.۰۴۱, OR (۹۵% CI): ۰.۱۱۵ (۰.۰۱۵-۰.۹۱۵)) were negatively associated with abortions. Active diseases prior to pregnancy (p-value: ۰.۰۰۵, OR (۹۵% CI): ۸.۸۹۳ (۱.۹۴۷-۴۰.۶۲۶)), anti-SSA/Ro (p-value: ۰.۰۰۱, OR (۹۵% CI): ۱۱.۴۸۲ (۲.۷۶۴-۴۷.۷۰۰)), and anti-cardiolipin IgM (p-value: ۰.۰۱۰, OR (۹۵% CI): ۱۱۵.۱۶۱ (۳.۰۶۵-۴۳۲۶.۵۶۲)) were associated with a higher risk of spontaneous abortion .Conclusion: A collaborative work of maternal-fetal specialists and rheumatologists could remarkably improve pregnancy outcomes .

کلیدواژه ها:

Abortion ، Spontaneous ، Antibodies ، Antiphospholipid ، Autoimmune Diseases ، Hydroxychloroquine ، Preconception Care ، Risk Factors