Normal Reproductive Outcomes in Women with Sjögren’s Disease Who Experience Pregnancies Before Disease Onset: A Multicentre Indian Cohort Study

Background: Sjögren’s disease (SS) is a chronic autoimmune disease with an estimated global prevalence of 6.9 per 100,000 person-years. However, population-based data from India are lacking. Information on reproductive health in Indian women with SS, particularly concerning marital status and pregnancy outcomes, is limited. Objective: To assess the impact of marital status on clinical and reproductive characteristics in women with SS and to compare pregnancy outcomes before and after disease onset among married women in India. Methods: This multicentre prospective observational study used data from the Indian Rheumatology Association (IRA) registry across seven centres. Female patients fulfilling the 2016 ACR/EULAR criteria for primary SS were included. Data on demographics, menstrual and reproductive history, and disease characteristics were collected using structured proformas. Reproductive health indicators were calculated using standard epidemiological methods. Results: Of 124 records, 115 female patients were included in the final analysis. The mean age at recruitment was 49.63 ± 10.31 years. The mean age at menarche was 13.74 ± 1.08 years, and 78.3% reported regular menstrual cycles. The mean age at disease onset was 41.34 ± 9.74 years, with a mean illness duration of 8.43 ± 5.4 years. Among married women ( n = 112), there were 236 pre-disease pregnancies resulting in 212 live births, with a CFR of 1.89. Pregnancy wastage ratio was 80.51 per 1,000 pregnancies, and stillbirth and abortion rates were 4.71 per 1,000 live births and 76.27 per 1,000 pregnancies, respectively. Vaginal delivery was the most common mode. Due to the very small number of unmarried participants ( n = 3) and those with pregnancy after disease onset ( n = 1), comparative analysis was not performed. Conclusion: Reproductive events in women with SS predominantly occurred before disease onset. Marital status was associated with age at diagnosis but not with adverse reproductive outcomes.