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Association between primary Sjögren’s syndrome and pregnancy complications: a systematic review and meta-analysis

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Abstract

Systemic autoimmune disorders may interfere with normal reproductive function resulting in negative outcome of pregnancy. Primary Sjögren’s syndrome (pSS) is a common rheumatic disease that mostly affects females. There are many reports that this condition may increase risk of pregnancy complications and fetal loss. However, data regarding these adverse outcomes are scarce and inconclusive. We performed a systematic review and meta-analysis of available articles that assess the association between pSS and adverse pregnancy outcome. We comprehensively searched the databases of MEDLINE and EMBASE from their dates of inception to March 2016 and reviewed papers with validity criteria. A random-effects model was used to evaluate pregnancy complications in patients with pSS and healthy controls. From 20 full-text articles, 7 studies involving 544 patients and 1586 pregnancies were included in the meta-analysis. Fetal complications included spontaneous abortion, stillbirth, neonatal deaths, and intrauterine growth retardation. Compared with healthy pregnancy, patients with pSS had significantly higher chance of neonatal deaths (pooled odds ratio (OR) = 1.77, 95 % confidence interval (CI) 1.28 to 1.46, p = 0.01). However, there were no significant associations between pSS and premature birth (OR = 2.10, 95 % CI 0.59–7.46, p = 0.25), spontaneous abortion (OR = 1.46, 95 % CI 0.72–2.93, p = 0.29), artificial abortion (OR = 1.12, 95 % CI 0.52–2.61, p = 0.71), or stillbirth (OR = 1.05, 95 % CI 0.38–2.97, p = 0.92). There is an increased risk of fetal loss in pregnant patients with pSS. The presented evidence further supports multidisciplinary care for these patients to prevent complications during pregnancy.

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Authors and Affiliations

  1. Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, 1 Atwell Rd, Cooperstown, NY, 13326, USA

    Sikarin Upala, Wai Chung Yong & Anawin Sanguankeo

  2. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Sikarin Upala & Anawin Sanguankeo

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  1. Sikarin Upala
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  2. Wai Chung Yong
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  3. Anawin Sanguankeo
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Correspondence to Wai Chung Yong.

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Search strategy (DOCX 14 kb)

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Flow diagram of the included studies (DOCX 32 kb)

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Upala, S., Yong, W.C. & Sanguankeo, A. Association between primary Sjögren’s syndrome and pregnancy complications: a systematic review and meta-analysis. Clin Rheumatol 35, 1949–1955 (2016). https://doi.org/10.1007/s10067-016-3323-9

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  • DOI: https://doi.org/10.1007/s10067-016-3323-9

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