PREGNANCY OUTCOME IN PATIENTS WITH CONNECTIVE TISSUE DISEASE (CTD) IN A TERTIARY CARE HOSPITAL

Abstract

Background: Connective tissue diseases (CTDs) are autoimmune disorders that primarily affect women of reproductive age. Their impact on pregnancy outcomes remains a significant concern, especially in low-resource settings where data is scarce.

Objective:This study aimed to evaluate maternal and fetal outcomes in pregnant women diagnosed with CTDs at a tertiary care hospital.

Methods: A prospective observational study was conducted at Jinnah Postgraduate Medical Centre, Karachi, involving 70 pregnant women with confirmed CTDs. Participants were followed throughout pregnancy and postpartum. Clinical data, treatment regimens, and outcomes were recorded and analyzed.

Results: Rheumatoid arthritis (RA) was the most prevalent CTD, followed by systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SS). Maternal complications included preeclampsia (53%), gestational diabetes mellitus (14%), and eclampsia (7%). Preeclampsia was most common in RA patients. Drug therapy analysis revealed that hydroxychloroquine, whether used alone or with methotrexate, was associated with increased risks of preeclampsia and GDM. Conversely, regimens including prednisolone and azathioprine were linked to better maternal outcomes.

Fetal outcomes varied by disease type. RA patients had the highest live birth rate (n=149), yet also experienced 58 miscarriages, 15 stillbirths, and 23 cases of intrauterine growth restriction (IUGR). SLE and SS groups demonstrated higher rates of fetal compromise, including miscarriages and growth restrictions.

Conclusion: CTDs significantly influence pregnancy outcomes. Early diagnosis, multidisciplinary care, and careful drug selection are crucial for improving maternal and fetal health in this high-risk population.