Maternal and infant outcomes in sarcoidosis pregnancy: a Swedish population-based cohort study of first births

Respiratory Research

Marios Rossides¹  Katarina Remaeus¹  Elizabeth V. Arkema¹  Laura Köcher¹  Johan Grunewald²  Anders Eklund²  Susanna Kullberg² 

[1] Clinical Epidemiology Division, T2, Department of Medicine Solna, Karolinska Institutet, 171 76, Stockholm, Sweden;Respiratory Medicine Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden;Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden;Department of Respiratory Medicine, Karolinska University Hospital, Stockholm, Sweden;

关键词: Sarcoidosis;    Pregnancy;    Infant;    Preeclampsia;    Cesarean delivery;    Preterm birth;    Birth defect;   

DOI  :  10.1186/s12931-020-01493-y

来源: Springer

【 摘 要 】

BackgroundIt is unclear whether sarcoidosis, a multisystem inflammatory disease, is associated with adverse pregnancy outcomes. We aimed to assess the risk of adverse maternal and infant outcomes in sarcoidosis pregnancies, focused on first births.MethodsUsing a population-based cohort study design and Swedish national registers (2002–2013), we identified 182 singleton first pregnancies in the Medical Birth Register with at least two maternal ICD-coded sarcoidosis visits prior to pregnancy in the National Patient Register. Modified Poisson regression models estimated relative risks (RR) of adverse outcomes in sarcoidosis pregnancies compared to the general population adjusted for maternal age at delivery, calendar year and educational level. Some models were additionally adjusted for maternal body mass index and smoking status.ResultsThe prevalence of pre-existing diabetes and hypertension was higher in mothers with sarcoidosis than those without sarcoidosis. Mothers with sarcoidosis had an increased risk of preeclampsia/eclampsia (RR 1.6; 95%CI 1.0, 2.6) and cesarean delivery (RR 1.3; 95%CI 1.0, 1.6). There were < 5 stillbirths and cases of infection and no cases of placental abruption, venous thromboembolism, cardiac arrest or maternal death. Newborns of first-time mothers with sarcoidosis had a 70% increased risk of preterm birth (RR 1.7; 95%CI 1.1, 2.5). There was an increased risk of birth defects (RR 1.6; 95%CI 0.9, 2.8) the majority of which were non-cardiac.ConclusionsSarcoidosis is associated with increased risks for preeclampsia/eclampsia, cesarean delivery, preterm birth and some birth defects. Awareness of these conditions may prevent possible pregnancy complications in mothers with sarcoidosis and their newborns.

【 授权许可】

CC BY