The impact of anti-SSA/Ro antibodies on pregnancy outcomes in patients with systemic lupus erythematosus.

Abstract

We aimed to investigate the influence of anti-SSA/Ro antibodies and other factors on adverse pregnancy outcomes (APOs) in patients with SLE. We retrospectively extracted data on first pregnancies after SLE onset from the Lupus Registry of Nationwide Institutions (LUNA, 2016-2022, n = 1775). We excluded patients with unclear anti-SSA/Ro status or pregnancy outcomes and cases of abortion. We used two-group comparison and logistic regression, adjusting for aPL, to analyse factors related to APOs and the influence of anti-SSA/Ro antibodies. The 247 pregnancies included 194 live births (122 full-term, 57 preterm, 15 unclear) and 53 foetal losses. Multivariate logistic regression showed foetal loss was associated with aPL [odds ratio (95% CI): 2.46 (1.21-5.01)] and a history of methylprednisolone pulse [2.89 (1.39-6.00)], but not anti-SSA/Ro [1.32 (0.64-2.74)]. No differences were found between anti-SSA/Ro positive (n = 145) and negative (n = 102) groups regarding live birth (anti-SSA/Ro positive vs negative, 77% vs 80%, P = 0.64) or preterm birth (31% vs 33%, P = 0.87). Clinical outcomes in a small subgroup were as follows (anti-SSA/Ro positive vs negative): birthweight, 2402 ± 586 g vs 2608 ± 449 g (P = 0.20); small for gestational age infants, 50% vs 8% (P = 0.11); and low birthweight infants, 67% vs 38% (P = 0.25). aPL showed an association with foetal loss in SLE, while anti-SSA/Ro antibodies did not. Anti-SSA/Ro may influence foetal development, necessitating further research.