Recently, reproductive factors have been studied in diffuse Systemic Sclerosis patients and pregnancy was not likely to be a risk factor for disease development. This findings need to be confirmed in the limited form of the disease. OBJECTIVE: To compare reproductive factors in 372 limited systemic sclerosis (LSSc) and 240 rheumatoid arthritis (RA) pregnancies and their relative risk for developing LSSc. METHODS: One hundred and seventeen LSSc and 72 RA consecutive female patients were interviewed with a detailed questionnaire to estimate the relative risk of developing LSSc given a relevant reproductive variable. The odds ratio (OR) was calculated using as reference nulliparous women and no history of miscarriage. RESULTS: Diagnosis of LSSc and RA was made after pregnancy for most patients of both diseases (97% vs. 90%, respectively, p > 0.05). A similar mean age at diagnosis (40.8 years old vs. 38.4 years old) and mean age of first pregnancy (22.7 years old vs. 23.5 years old) were noted in LSSc and RA (p > 0.05), respectively. The number of pregnancies/patient (3.1 vs. 3.3), percentage of patients ever pregnant (84.6% vs. 88.8%) and miscarriage (19.8% vs. 21.6%) was similar in both groups (p > 0.05). Compared to nulliparous women, parous LSSc had an OR of 0.7, 95% CI 0.3-1.7 for developing LSSc and, for women who experienced a miscarriage, the [OR] was 0.9, 95% CI 0.5-1.6, compared with those LSSc patients with no miscarriage. In addition to that, the number of pregnancies was not associated with an increased risk for LSSc when compared to nulliparous controls. CONCLUSIONS: These data suggest that the overall reproductive history of LSSc is comparable to RA. Moreover, it indicates that pregnancy is unlikely to account for an increased risk or a protective effect to develop LSSc in comparison to RA.
systemic sclerosis; pregnancy; microchimerism; rheumatoid arthritis; reproductive factors
