POS0429 SJÖGRENS'S SYNDROME AND COURSE OF PREGNANCY - RESULTS FROM THE NATIONWIDE PREGNANCY REGISTER RevNatus

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Background: Primary Sjögren's syndrome (pSS) is an autoimmune disorder characterized by focal lymphocytic infiltration of the exocrine glands causing dry eyes and dry mouth. Affection of internal organs like the kidneys may occur. Most affected women are diagnosed after fertile age, however some are diagnosed during reproductive age. Pregnancy outcomes are reported in previous studies with discrepancies in the rate of pregnancy-related complications [1, 2] and international classification criteria for pSS have changed during the last decades. Objectives: To describe the course of pregnancy in patients with pSS. Methods: We prospectively collected data on pregnancy outcome in women with pSS through the nationwide Norwegian registry on pregnancy and rheumatic diseases (RevNatus) from 2016-2024. All women were diagnosed with ICD-10 kode M35.0 prior to pregnancy. 111 pregnancies in 92 women were recorded. Two women had three pregnancies and 15 women had two pregnancies. No multiple gestation pregnancies were recorded. Results: 102 of 111 pregnancies ended in live births. Mean maternal age at first trimester was 32.1 years (SD = 4.4). Five patients had BMI > 30 at first trimester (mean = 24.4, SD=4.7), but no other comorbidities were recorded. 96 % of the women were in clinical remission/persistent disease at 2 nd trimester and 94% were Anti-SS-A/Ro positive. Hydroxychloroqiune (HCQ) was used by 67 % during pregnancy. Most pregnancies (81%) were planned and most women (70.1 %) had received counselling regarding their diagnosis and pregnancy. Median gestational age at delivery was 39 weeks (range 30-42). No stillbirths nor neonatal lupus syndrome or congenital heart block were recorded. Conclusion: Most patients with pSS in this cohort had a favourable course and outcome of pregnancy, and most pregnancies were planned and with prior counselling. The scores on patient reported VAS-scales (pain, fatigue and global assessment of disease activity) were relatively stable throughout pregnancy with highest scores on VAS-fatigue. HCQ was used by a majority of the women, most women were in remission at 2 nd trimester, and there were no organ manifestations reported. This might have contributed to the favorable course and outcome. REFERENCES: [1] Geng B, Zhang K, Huang X, Chen Y. A meta-analysis of the effect of Sjögren's syndrome on adverse pregnancy outcomes. Clinics (Sao Paulo). 2022 Nov 17;77:100140. doi: 10.1016/j.clinsp.2022.100140. [2] de Frémont GM, Costedoat-Chalumeau N, Lazaro E, et al. GR2 Study Group. Pregnancy outcomes in women with primary Sjögren's syndrome: an analysis of data from the multicentre, prospective, GR2 study. Lancet Rheumatol. 2023 Jun;5(6):e330-e340. doi: 10.1016/S2665-9913(23)00099-1. Table 1At enrollment (N=111)1. trimester(N=73)2.trimester(N=91)3.trimester(N=98)delivery(N= 111)6 weekspost partum (N=111)CRP in mg/l mean (SD)4.9 (8.6)4.8 (9.7)4.9 (5.3)5.6 (10.9)3.4 (7.5)CRP >5mg/l n (%)19 (17)14 (12.6)17 (18.6)18 (18.3)7 (6.3)patient global (VAS 0-100), mean (SD)38.3 (27.5)36.2 (29.3)36.7 (25.6)40.3 (23.7)34.0 (25.9)patient pain (VAS 0-100), mean (SD)28.8 (24.9)21.7 (22.6)29.5 (25.7)35.7 (26.0)31.6 (27.8)patient fatigue (VAS 0-100), mean (SD)52.4 (27.7)58.0 (25.1)49.5 (32.1)54.7 (25.5)43.9 (27.8)Miscarriages ≤ week 12, n (%)6 (5.4)Miscarriages > week 12, n (%)3(2.7)Birth weight (gram)of singelton, mean3274 (521)Birth weight (gram) of singelton born at term, mean (SD)3331 (472)Preeclampsia n (%)4 (3.6)HELLP n (%)1 (0.9)Vaginal delivery n (%)69 (62)Caesarean sectionplanned, n (%)8 (7)Caesarean sectionacute, n (%)9 (8) Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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