Pregnancy outcomes of a joint obstetric and rheumatology clinic in a tertiary centre: a 2-year retrospective study of 98 pregnancies

Objectives The purpose of this study is to describe the maternal and foetal outcomes in patients with inflammatory rheumatic diseases (IRDs) attending a joint rheumatology and obstetric clinic in the United Kingdom. Methods Electronic records of 98 patients attending the joint rheumatology and obstetric clinic between Jan 2018-Jan 2020 were analysed. Data on patient demographics, characteristics (including age, ethnicity, diagnosis, and medications taken during pregnancy), pregnancy outcomes (miscarriage, stillbirth, livebirth), maternal complications (infection, postpartum haemorrhage (PPH), pre-eclampsia), and foetal complications (sepsis, congenital heart block (CHB), prematurity, and low birthweight), were tabulated. Subgroups of patients based on maternal diagnosis, medications, and Ro/La antibody status were similarly described. Results The cohort was found to be predominantly Caucasian women above the age of 30, diagnosed with a connective tissue disease. Of 98 pregnancies, 97% (n = 95) resulted in a livebirth, with only 2% resulting in miscarriage (n = 2), and 1% in stillbirth (n = 1). The median age of gestation was 38 (IQR 37-39), and the majority of patients had a normal vaginal delivery (35%, n = 34), whilst 30% had emergency caesarean-sections (n = 29). Median birthweight was 3120g (IQR 2690-3410). The most common maternal complications were PPH (56%, n = 54) and infection (22%, n = 21). The most common foetal complications were prematurity (23%, n = 22) and low birthweight (17%, n = 16). Conclusion We report favourable outcomes from this service model, including a high live birth-rate, low miscarriage rate, and a high median birthweight. With limited reported data of pregnancy outcomes from joint obstetric/rheumatology clinics, this service model may be beneficial in other centres.