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Reproductive Outcomes and Fertility Patterns in Women with Systemic Sclerosis: A Multicentre Observational Study.

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Summary

Systemic sclerosis (SSc) in Indian women is linked to reduced fertility and higher pregnancy loss. Early SSc onset impacts marriage and reproduction, necessitating specialized care for better outcomes.

Keywords:
abortioncaesarean sectionfemale reproductive healthfertilitypregnancy complicationssystemic sclerosis

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Area of Science:

  • Rheumatology
  • Obstetrics & Gynecology
  • Reproductive Medicine

Background:

  • Limited data exist on reproductive patterns in Indian women with systemic sclerosis (SSc).
  • Understanding fertility and pregnancy complications is crucial for patient counseling and management in this population.

Purpose of the Study:

  • To evaluate reproductive patterns, fertility outcomes, and pregnancy complications in Indian women with SSc.
  • To compare outcomes between married and unmarried women, and between pregnancies before and after SSc onset.

Main Methods:

  • Data were extracted from the Indian Rheumatology Association registry.
  • 131 female patients meeting ACR/EULAR 2013 criteria for SSc were analyzed.
  • Reproductive history, fertility rates, and pregnancy outcomes were compared based on marital status and disease onset.

Main Results:

  • Married women experienced later SSc onset and more comorbidities compared to unmarried women.
  • Post-disease pregnancies occurred at a younger age at disease onset.
  • While parity and abortion rates were similar, vaginal deliveries decreased and C-sections increased post-disease onset. Cumulative fertility rate was 1.68, with a pregnancy wastage ratio of 125/1,000 pregnancies.

Conclusions:

  • Women with SSc demonstrate reduced fertility and increased pregnancy loss.
  • Early-onset SSc negatively affects marital prospects and reproductive potential.
  • Multidisciplinary care, including preconception counseling and vigilant monitoring, is vital for optimizing maternal and fetal outcomes in SSc patients.