Inflamed Pathways to Motherhood: Evaluating Obstetric and Neonatal Outcomes in Rheumatic Pregnancies.

Area of Science:

• Obstetrics and Gynecology
• Rheumatology
• Neonatology

Background:

• Pregnancies complicated by rheumatic diseases (RDs) present unique challenges for both maternal and fetal health.
• Understanding specific risks associated with different RDs and identifying predictive biomarkers is crucial for improved perinatal care.

Purpose of the Study:

• To evaluate obstetric and neonatal outcomes in pregnancies affected by various RDs.
• To identify hemogram-derived inflammatory markers that predict adverse perinatal events.

Main Methods:

• A retrospective cohort study of 360 pregnancies with diagnosed RDs (including RA, SLE, SSc, AS, Sjögren's disease, sarcoidosis, UCTD).
• Data extraction from electronic medical records for disease activity, maternal complications, neonatal outcomes, and inflammatory markers.
• Analysis of hemogram-derived ratios such as NLR, ELR, and MLR for predictive value.

Main Results:

• Systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) were associated with the highest rates of preterm birth, fetal growth restriction, and disease flares.
• Lower Apgar scores and increased NICU admissions were observed in neonates of mothers with SSc, SLE, and Sjögren's disease.
• Elevated NLR, ELR, and MLR were linked to NICU admission, spontaneous abortion, and composite adverse perinatal outcomes.

Conclusions:

• RD pregnancies, especially those with SSc and SLE, face significantly increased risks of preterm birth, FGR, and neonatal complications.
• Hemogram-based inflammatory markers (NLR, ELR, MLR) show promise as early risk assessment tools for stratifying patients and improving perinatal management.