Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Gynecologic and Obstetric History IN Systemic Sclerosis (SSC) PATIENTS IN Spain: A Case Control Study

Dorado,  N., Perez,  M., Roldan,  MA, Piedrabuena,  SI, Joven,  BE, Carreira,  PE.

Purpose:

To analyze: 1.gynecologic and obstetric (gyn-obs) history in systemic sclerosis (SSc) patients, compared with healthy controls; 2.the influence of SSc in patients gyn-obs history; and 3.if this influence is different in SSc subgroups.

Method:

A semistructured questionnaire on gyn-obs history was sent to all SSc women followed between 1995–2008 in the rheumatology department of a University Hospital, and to an age-matched control group, comprised by women seen in rheumatology because of mechanical problems, without any evidence of autoimmune disease. SSc patients information: age at onset, SSc subgroup (diffuse or limited), clinical data (lung, renal or cardiac involvement, pulmonary hipertension (PH), antibodies (ANA, anticentromere (ACA), a-Scl70)), had been previously included in a prospective database containing demographic and clinical information. The following groups were analyzed: whole SSc and control group; patients and control older than 45; control group with SSc subgroups (diffuse, limited, ACA (+), aScl70 (+), with interstitial lung disease); control group with SSc patients with disease onset before 35; SSc diffuse and limited; SSc ACA (+) and (-); SSc aScl70 (+) and (-). Chi square and t test were used to analyze differences between groups. Univariate logistic regression was used to analyze the influence of SSc presence in gyn-obs history.

Results:

Questionnaire was answered by 98/150 SSc patients and 94/150 controls, with a mean age of 55±15 and 52±12 years, respectively. In the SSc group, 63(64%) had limited and 35(36%) diffuse disease, 25(27%) had lung involvement, 26(28%) had aScl70 and 41(43%) had ACA. The only difference in the gynecologic history was less frequent use of postmenopausal hormonal substitutive therapy (HST) in SSc group (OR=0.3; 95%CI 0.1–0.7; p= 0.005). In obstetric history, SSc patients have been ever pregnant (OR=0.44; 95%CI 0.2–0.9; p= 0.02), and have had the intention to become pregnant less frequently (OR= 0.5; 95%CI 0.2– 0.9; p= 0.04) than controls. There were no differences between ever pregnant women in number of pregnancies or percentage of alive new-born. Similar results were obtained when women older than 45 years were analyzed. These differences were higher when only diffuse SSc or aScl70 (+) patients were analyzed, but were not present when only limited or ACA (+) patients were analyzed. Patients with SSc onset before 35 years were less frequently pregnant (OR=0,2; 95%CI=0.1–0.6; p=0.004), and have had ever the intention to become pregnant (OR=0.3; 95%CI=0.1–0.6; p=0.004), than age adjusted controls. When analyzing subgroups of SSc patients, diffuse and aScl70 (+) patients showed similar results. Menopause happened at earlier age (p=0.001) and was not natural more often in the diffuse and aScl70 subgroups (OR=0.1; 95%CI= 0,03-0,5; p=0,003)

Conclusion:

SSc patients, especially those with diffuse disease or aScl70 antibodies, are less often ever pregnant and have less intention to become pregnant than healthy controls. These is confirmed for patients with disease onset before 35 years. SSc patients are less frequently treated with HST after menopause. Menopause occurs earlier and is more often not natural in SSc patients with diffuse disease and aScl70 antibodies.

To cite this abstract, please use the following information:
Dorado, N., Perez, M., Roldan, MA, Piedrabuena, SI, Joven, BE, Carreira, PE.; Gynecologic and Obstetric History IN Systemic Sclerosis (SSC) PATIENTS IN Spain: A Case Control Study [abstract]. Arthritis Rheum 2009;60 Suppl 10 :467
DOI: 10.1002/art.25549

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