Pregnancy outcome in systemic sclerosis

The outcome of pregnancy in systemic scleroderma (SSc) has been a subject of much interest. In a retrospective analysis of 59 pregnancies of 17 mothers with SSc, the effect of disease on pregnancy outcome was variable. There was no adverse effect on fertility. While there was an apparent decrease in fertility in the limited cutaneous disease, this was not seen in the diffuse variety. There was an decreased incidence of live birth after the onset of disease as compared prior to the onset of disease. The foetal wastage after the onset of disease was contributed equally by spontaneous abortions as well as induced terminations of pregnancies. The presence of anticardiolipin antibodies was not related with adverse outcome. The effect of pregnancy on disease was variable with the disease being stable in five patients, regressing in five and progressing in three. The increased terminations of pregnancy reflects the uncertainties of a positive outcome both by parent and attending physicians.