Ab0825 the Risk of Heart Diseases in Offspring Born to Mothers With Primary Sjögren’s Syndrome: A Multi-Center Retrospective Study

Background: The effect of primary Sjögren's syndrome (pSS) on adverse pregnancy outcomes is a controversial topic. Offspring born from mothers with pSS were more likely to have adverse neonatal heart diseases. Objectives: This study investigated the association between maternal pSS and the risk of cardiac disorders in infants. Methods: A multi-center, retrospective cohort study was conducted, which included pregnant women treated between January 2015 and January 2023 who fulfilled classification criteria for pSS. Pregnant women with pSS were included in five hospitals from Anhui province in China (i.e., the First Affiliated Hospital of USTC, University of Science and Technology of China, The People's Hospital of Chizhou, Huainan First People's Hospital, Maanshan People's Hospital and Huangshan City People's Hospital). Demographic data, relevant comorbidities, disease duration, disease activity before and during pregnancy, adverse pregnancy outcomes, laboratory parameters and treatment regimens were recorded. Associations between the presence of adverse pregnancy outcomes, and preconception characteristics were evaluated. Ethics committee of the above five centers approved the research. Informed consents were obtained from the participants. Results: In this study, a total of 128 newborns delivered by pSS patients, with 38 cases of newborns with combined neonatal heart diseases and 90 cases of newborns without heart diseases were enrolled. Among the 38 newborns with cardiac abnormalities, there were 27 cases of myocardial injuries, 18 cases of atrial/ventricular septal defects, 1 case of pulmonary hypertension, and 1 case of coarctation of the aorta. The study found that newborns with cardiac diseases had a higher rate of premature birth [28/38(73.68%) vs. 84/90 (93.33%), P=0.005], lower birth weight [7/38(18.42%) vs. 3/90 (3.33%), P=0.011], and were more prone to intrauterine distress [8/38(21.05%) vs. 6/90 (6.67%), P=0.038], brain injury [6/38(15.79%) vs. 0/90 (0 %), P<0.001], neonatal infection [19/38(50.0%) vs. 3/90 (3.33%), P<0.001], and anemia [4/38(10.53%) vs. 0/90 (0 %), P=0.010] compared to control newborns. During pregnancy, pregnant women with pSS who gave birth to newborns with heart diseases were more likely to have umbilical cord abnormalities [21/38(55.26%) vs. 31/90 (34.44%), P=0.028] and preterm labor [7/38(18.42%) vs. 2/90 (2.22%), P=0.004]. pSS patients with a disease duration of more than 5 years [10/38(26.32%) vs. 11/90 (12.22%), P=0.049], and those using steroids [35/38(92.11%) vs. 66/90 (73.33%), P=0.017], cyclosporine [5/38(13.16%) vs. 1/90 (1.11%), P=0.013], lower C3 level in late trimester of pregnancy[1.13±0.21 vs. 1.28±0.18, P=0.008], or higher ESSDAI [3.08±3.19 vs. 1.46±1.99, P=0.028] were more likely to give birth to newborns with combined heart diseases. The independent risk factor for the occurrence of neonatal cardiac diseases in pregnant women with pSS was ESSDAI level [OR 1.516,95%CI (1.155, 1.989), P=0.003] by logistic regression analysis. Conclusion: We found that pregnancies in women with pSS can lead to neonatal cardiac disorders. Women with high disease activity require close monitoring, because these factors might be associated with a higher risk of cardiovascular diseases and myocardial injury. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.