Pregnancy outcome and autoantibodies in connective tissue disease

Pregnancy outcome before and after onset of disease and the association with present levels of anticardiolipin antibodies (aCL) and other autoantibodies were investigated in rheumatoid arthritis (RA) (117 patients), systemic lupus erythematosus (SLE) (74 patients), and systemic sclerosis (28 patients). Although 78% of the 81 pregnancies in patients with systemic sclerosis occurred before disease onset, pregnancy loss rate was highest in this disease (44%) but in RA (17%) and SLE (18%) was similar to a control population (16%). Elevated levels of IgG aCL were present in one of 4 patients with RA, in one of 5 patients with systemic sclerosis and in the only patient with SLE to have recurrent previous pregnancy loss. Congenital heart block occurred in one of 28 pregnancies from 17 anti-Ro (SSA) positive women with SLE.