Reproductive health in female patients with systemic sclerosis: a cross-sectional study

Liyi Dai; Dan Xu; Xinyi Li; Sicheng Huang; Xiangyue Duan; Ai Zheng; Jing Yang; Jie Zhao; Lin Zeng; Rong Mu

doi:10.1093/rheumatology/kead497

Reproductive health in female patients with systemic sclerosis: a cross-sectional study

Rheumatology (Oxford). 2023 Sep 20:kead497. doi: 10.1093/rheumatology/kead497. Online ahead of print.

Authors

Liyi Dai^{1

2}, Dan Xu^{1

2}, Xinyi Li^{1

2}, Sicheng Huang³, Xiangyue Duan³, Ai Zheng⁴, Jing Yang⁴, Jie Zhao⁵, Lin Zeng⁶, Rong Mu^{1

2}

Affiliations

¹ Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
² Center for Rare Disease, Peking University Third Hospital, Beijing, China.
³ Department of Clinical Medicine, Peking University, Beijing, China.
⁴ Chinese Organization for Scleroderma, Chengdu, China.
⁵ Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China.
⁶ Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.

PMID: 37738273
DOI: 10.1093/rheumatology/kead497

Abstract

Objectives: To explore the status of reproductive health and related factors in female patients with systemic sclerosis (SSc).

Methods: A cross-sectional study was conducted among female patients from the Chinese Organization for Scleroderma through a questionnaire. Data on the status of reproductive health including fertility condition and menstrual status were obtained. The clinical and laboratory data of SSc were collected. For patients with pregnancies after disease onset, each pregnancy was matched with a healthy control. Associations between clinical characteristics and the status of reproductive health were analyzed.

Results: A total of 342 female patients with SSc were included, and 31.8% (108/342, 95% CI 26.9%-36.7%) of them presented problems with reproductive health. Compared with the national data, the menopausal age of patients with disease onset before menopause was earlier (45.2 ± 6.1 vs 48.2 ± 4.4, P＜ 0.001). Age of disease onset (p = 0.018) and digital ulcer (p = 0.020) had statistically significant effects on menopausal age. Although the infertility rate of patients was not increased, the rate of spontaneous abortions was higher compared with the national data (9/74, 12.2% vs 4.3%, P＜ 0.001). Compared with the healthy control group, the rate of premature infants (12/55, 21.8% vs 7/110, 6.4%, p = 0.003), low birth weight infants (15/55, 27.3% vs 6/110, 5.5%, P＜ 0.001), and cesarean section (27/55, 49.1% vs 21/110, 19.1%, P＜ 0.001) increased significantly.

Conclusion: The impairment of reproductive health is common and in many quarters in patients with SSc. Further action should be taken to improve reproductive health in patients with SSc, especially in maternal care.

Keywords: Systemic sclerosis; fertility; menopause; pregnancy; reproductive health; women’s health.