A meta-analysis of the effect of Sjögren′s syndrome on adverse pregnancy outcomes

Geng, Baoqing; Zhang, Keyue; Huang, Xianqian; Chen, Yong

doi:10.1016/j.clinsp.2022.100140

Cited by 5 publications

(8 citation statements)

References 23 publications

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“…A substantial correlation between congenital heart block and anti-Ro/SS-A and anti-La/SS-B have been demonstrated in previous studies [ 38 – 40 ]. A meta-analysis of nine studies suggested that SS was highly associated with preterm birth (RR = 2.27, 95% CI 1.46‒3.52) and low birth mass (RR = 1.99, 95% CI 1.34‒2.97) [ 37 ], and this conclusions were also similar to our results. Additionally, a literature review including seven studies by Sara et al showed that pSS patients could accompanied with distinct increases of spontaneous abortions, preterm deliveries and cesarean section [ 12 ], and presented that pSS was responsible for adverse clinical outcomes.…”

Section: Discussionsupporting

confidence: 91%

“…Hence, we still emphasize the need for a combination of pSS treatments, a comprehensive fertility evaluation, and ART treatments for a comprehensive range of therapeutic options. Additionally, many prior studies reported that pSS may be associated with preterm birth, low birthweight and neonatal defects especially neonatal heart block [ 34 , 36 , 37 ]. A substantial correlation between congenital heart block and anti-Ro/SS-A and anti-La/SS-B have been demonstrated in previous studies [ 38 – 40 ].…”

Section: Discussionmentioning

confidence: 99%

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A new insight on evaluation of the fertility and pregnancy outcome in patients with primary Sjögren syndrome: a propensity score matched study in multi-IVF centers

Mao,

Zhu,

Long

et al. 2024

Reprod Biol Endocrinol

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Background Primary Sjögren syndrome (pSS) is often related to adverse neonatal outcomes. But it’s currently controversial whether pSS has an adverse effect on female fertility and clinical pregnancy condition. More importantly, it’s unclear regarding the role of pSS in oocyte and embryonic development. There is a lack of comprehensive understanding and evaluation of fertility in pSS patients. Objective This study aimed to investigate oocyte and embryonic development, ovarian reserve, and clinical pregnancy outcomes in Primary Sjögren syndrome (pSS) patients during in vitro fertilization (IVF) treatment from multi-IVF centers. Methods We performed a muti-central retrospective cohort study overall evaluating the baseline characteristics, ovarian reserve, IVF laboratory outcomes, and clinical pregnancy outcomes between the pSS patients and control patients who were matched by Propensity Score Matching. Results Following PSM matching, baseline characteristics generally coincided between the two groups. Ovarian reserve including anti-müllerian hormone (AMH) and antral follicle counting (AFC) were significantly lower in the pSS group vs comparison (0.8 vs. 2.9 ng/mL, P < 0.001; 6.0 vs. 10.0, P < 0.001, respectively). The pSS group performed significant reductions in numbers of large follicles, oocytes retrieved and MII oocytes. Additionally, pSS patients exhibited obviously deteriorate rates of oocyte maturation, 2PN cleavage, D3 good-quality embryo, and blastocyst formation compared to comparison. As for clinical pregnancy, notable decrease was found in implantation rate (37.9% vs. 54.9%, P = 0.022). The cumulative live birth rate (CLBR) following every embryo-transfer procedure was distinctly lower in the pSS group, and the conservative and optimal CLBRs following every complete cycle procedure were also significantly reduced in the pSS group. Lastly, the gestational weeks of the newborns in pSS group were distinctly early vs comparison. Conclusion Patients with pSS exhibit worse conditions in terms of female fertility and clinical pregnancy, notably accompanied with deteriorate oocyte and embryo development. Individualized fertility evaluation and early fertility guidance are essential for these special patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

A new insight on evaluation of the fertility and pregnancy outcome in patients with primary Sjögren syndrome: a propensity score matched study in multi-IVF centers

Mao,

Zhu,

Long

et al. 2024

Reprod Biol Endocrinol

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“…Higher risk of miscarriage was reported in women with Sjögren’s syndrome relative risk (RR) 8.85 (3.10–25.26) or SLE OR 4.90 (3.10–7.69) respectively [ 32 , 114 ]. In the presence of thyroid autoimmunity (all antibodies), the risk was almost threefold (OR 2.77 (2.10–3.65)) [ 111 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were more than fourfold higher odds of preterm birth for women with T1DM (OR 4.36 (3.72–5.12)). The odds of preterm birth were also higher in women with SLE (OR 2.79 (2.07–3.77)) and in women with Sjögren’s syndrome (RR 2.27 (1.46–3.52)) [ 32 , 110 , 114 , 129 ]. There was a significant association for preterm birth in women with coeliac disease (OR 1.30 (1.13–1.50)), IBD (OR 1.81 (1.37–2.38)), psoriatic diseases (psoriasis OR 1.22 (1.04–1.42), psoriatic arthritis OR 1.48 (1.24–1.78)), rheumatoid arthritis (OR 1.57 (1.00, 2.48)), and systemic sclerosis (OR 2.40 (1.14–4.86)) and for thyroid autoimmunity (all) (OR 1.88 (1.32–2.67) and thyroid autoimmunity (TPO) (OR 1.33 (1.15–1.56)) when compared to women without these conditions [ 29 , 31 , 32 , 35 , 97 , 109 , 110 , 117 , 128 , 131 ].…”

Section: Resultsmentioning

confidence: 99%

“…The odds of giving birth to a baby with a low birth weight (< 2500 g) was 4–6 times higher in women with SLE or systemic sclerosis (OR 5.95 (4.54–7.80) and OR 3.80 (2.16–6.56), respectively) [ 29 , 32 ]. There was a significant association for women with IBD (OR 2.25 (1.37–3.69)), coeliac disease (OR 1.63 (1.06–2.51)), rheumatoid arthritis (OR 1.73 (1.46, 2.06)), or Sjögren’s syndrome (RR 1.99 (1.34–2.97)) [ 31 , 114 , 117 , 122 , 131 ]. There were higher odds of having a low-birth-weight infant for women with Crohn’s disease (OR 2.82 (1.42–5.60)), but the association was not significant for women with ulcerative colitis (OR 1.66 (0.48–5.66)) [ 33 , 34 , 112 ].…”

Section: Resultsmentioning

confidence: 99%

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Autoimmune diseases and adverse pregnancy outcomes: an umbrella review

Singh,

Wambua,

Lee

et al. 2024

BMC Med

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Background There is a high prevalence of autoimmune conditions in women specially in the reproductive years; thus, the association with adverse pregnancy outcomes has been widely studied. However, few autoimmune conditions/adverse outcomes have been studied more than others, and this umbrella review aims to consolidate existing knowledge in this area with the aim to provide new knowledge and also identify gaps in this research area. Methods Medline, Embase, and Cochrane databases were searched from inception to December 2023. Screening, data extraction, and quality appraisal (AMSTAR 2) were done by two independent reviewers. Data were synthesised narratively and quantitatively. Relative risks (RR)/odds ratio (OR) with 95% confidence intervals were reported. Results Thirty-two reviews were included consisting of 709 primary studies. The review reported the association between 12 autoimmune conditions and 16 adverse pregnancy outcomes. Higher risk of miscarriage is reported in women with Sjögren’s syndrome RR 8.85 (95% CI 3.10–25.26) and systemic lupus erythematosus (SLE) OR 4.90 (3.10–7.69). Pre-eclampsia was reported higher in women with type 1 diabetes mellitus (T1DM) OR 4.19 (3.08–5.71) and SLE OR 3.20 (2.54–4.20). Women reported higher risk of diabetes during pregnancy with inflammatory bowel disease (IBD) OR 2.96 (1.47–5.98). There was an increased risk of intrauterine growth restriction in women with systemic sclerosis OR 3.20 (2.21–4.53) and coeliac disease OR 1.71 (1.36–2.14). Preterm birth was associated with T1DM OR 4.36 (3.72–5.12) and SLE OR 2.79 (2.07–3.77). Low birth weight babies were reported in women with women with SLE or systemic sclerosis OR 5.95 (4.54–7.80) and OR 3.80 (2.16–6.56), respectively. There was a higher risk of stillbirth in women with T1DM OR 3.97 (3.44–4.58), IBD OR 1.57 (1.03–2.38), and coeliac disease OR 1.57 (1.17–2.10). T1DM in women was associated with 32% lower odds of small for gestational age baby OR 0.68 (0.56–0.83). Conclusions Pregnant women with autoimmune conditions are at a greater risk of developing adverse pregnancy outcomes. Further research is required to develop better preconception to postnatal care for women with autoimmune conditions.

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Impact of Sjögren’s syndrome on maternal and fetal outcomes following pregnancy: a systematic review and meta-analysis of studies published between years 2007–2022

Yang,

Huang,

Huo

et al. 2023

Arch Gynecol Obstet

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A meta-analysis of the effect of Sjögren′s syndrome on adverse pregnancy outcomes

Cited by 5 publications

References 23 publications

A new insight on evaluation of the fertility and pregnancy outcome in patients with primary Sjögren syndrome: a propensity score matched study in multi-IVF centers

A new insight on evaluation of the fertility and pregnancy outcome in patients with primary Sjögren syndrome: a propensity score matched study in multi-IVF centers

Autoimmune diseases and adverse pregnancy outcomes: an umbrella review

Impact of Sjögren’s syndrome on maternal and fetal outcomes following pregnancy: a systematic review and meta-analysis of studies published between years 2007–2022

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