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

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OBJECTIVE: We aimed to investigate the influence of anti-SSA/Ro antibodies and other factors on adverse pregnancy outcomes (APOs) in patients with SLE. METHODS: 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. RESULTS: 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). CONCLUSION: 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.

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