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Licensed Unlicensed Requires Authentication Published by De Gruyter July 9, 2019

Effect of Sjögren’s syndrome on maternal and neonatal outcomes of pregnancy

  • Brittney Elliott , Andrea R. Spence , Nicholas Czuzoj-Shulman and Haim Arie Abenhaim EMAIL logo



Sjögren’s syndrome (SS) is an autoimmune connective tissue disease affecting the body’s moisture-producing glands. Some studies have linked SS to adverse maternal/neonatal outcomes, but sample sizes have tended to be small, with few outcomes examined. The purpose of this study was to evaluate the effect of SS on pregnancy outcomes for mother and neonate using a large dataset.


We carried out a retrospective cohort study of women who delivered between 1999 and 2014 using data from the Nationwide Inpatient Sample from the United States. SS categorization is based on ICD-9 coding. Baseline characteristics were compared in both groups and multivariate logistic regression was used to compare maternal and fetal outcomes of pregnancies in women with and without SS.


The prevalence of SS in our population was 1.34 cases/10,000 births, with the rate increasing over the study period. Women with SS tended to be older, Caucasian and to have pre-existing comorbidities. Births to women with SS were at greater risk of pre-eclampsia [odds ratio (OR) 1.63, 95% confidence interval (CI) 1.34–1.99]; premature rupture of membranes (OR 1.28, 95% CI 1.04–1.57); preterm delivery (OR 1.56, 95% CI 1.34–1.81); cesarean delivery (OR 1.29, 95% CI 1.17–1.41); and venous thromboembolic events (OR 3.71, 95% CI 2.57–5.35). Infants of women with SS were more likely to have intrauterine growth restriction (IUGR) (OR 3.00, 95% CI 2.46–3.65); and congenital malformations (OR 3.26, 95% CI 2.30–4.62).


SS is a high-risk pregnancy condition associated with significant comorbidities and adverse maternal and fetal outcomes. Women with SS may benefit from increased surveillance during their pregnancies.

Corresponding author: Haim Arie Abenhaim, MD, MPH, FRCSC, Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Pav H, Room 325, 5790 Cote-Des-Neiges Road, Montreal, Quebec H3S 1Y9, Canada; and Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, QC, Canada, Tel.: +514-340-8222x24187, Fax: +514-340-7941

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Received: 2019-01-31
Accepted: 2019-05-28
Published Online: 2019-07-09
Published in Print: 2019-08-27

© 2019 Walter de Gruyter GmbH, Berlin/Boston

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