RT Journal Article SR Electronic T1 Pregnancy in systemic sclerosis (SSc): results of systematic review and meta-analysis JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.181460 DO 10.3899/jrheum.181460 A1 Jelena Blagojevic A1 Khitam Abdullah AlOdhaibi A1 Aly M Aly A1 Silvia Bellando–Randone A1 Gemma Lepri A1 Cosimo Bruni A1 Alberto Moggi-Pignone A1 Serena Guiducci A1 Federico Mecacci A1 Marco Matucci-Cerinic A1 Daniel E Furst YR 2019 UL http://www.jrheum.org/content/early/2019/08/25/jrheum.181460.abstract AB Objective Through a systemic literature research (SLR) and meta-analysis, to determine maternal and foetal outcomes in SSc pregnancies, to analyse the effect of pregnancy on disease activity and to explore predictors of foetal and maternal outcomes. Methods A SLR was performed for articles on SSc and pregnancy published between 1950 and 1st February 2018. Reviewers double extracted articles to obtain agreement on>95% of pre-defined critical outcomes. Results 461 publications were identified, 16 were included in the meta-analysis. The metanalysis showed that SSc pregnancies were at higher risk of miscarriages (OR 1.6,CI95% 1.22-2.22), foetuses with intrauterine growth retardation (IUGR) (OR 3.2,CI95% 2.21-4.53), preterm births (OR 2.4,CI95% 1.14-4.86) and newborns with low birth weight (OR 3.8,CI95% 2.16-6.56). SSc patients had 2.8 times higher chance of developing gestational hypertension (OR 2.8,CI95% 2.28-3.39) and 2.3 times higher chance of having Caesarean delivery compared to controls (OR 2.3,CI95% 1.37-3.8). The definitions of disease worsening/new visceral organ involvement were too inexact to have any confidence in the results although there were said to be worsening or new disease manifestations during pregnancy in 44/307(14.3%) cases and during the 6-months post-partum in 32/306(10.5%) cases. The data did not permit definition of predictors of disease progression and of maternal and foetal outcomes. Conclusion SSc pregnancies have increased frequency of miscarriages, IUGR, pre-term deliveries and newborns with low birth weight compared to healthy controls. SSc women were more prone to develop gestational hypertension and to undergo Caesarean section. Disease manifestations seem to remain stable or improve in most patients.