(1190) Presence of SSA/SSB antibodies and risk of preeclampsia in patients with autoimmune disease

The presence of anti-Sjogren’s syndrome-related antibody A (SSA) or B (SSB) in pregnant patients is associated with neonatal lupus and heart block. However, data on adverse maternal outcomes is limited. We hypothesized these antibodies are associated with a higher risk of adverse maternal outcome. We sought to assess the association of SSA/SSB antibodies with the development of preeclampsia and other adverse obstetric outcomes in gravidas with autoimmune disease.

Study Design:

This is a historical matched case-control study of all patients with positive SSA or SSB antibodies from 1/2010 to 8/2022 who delivered at a tertiary referral center. The study group was matched by age, parity, and autoimmune disease to gravidas with autoimmune disease without SSA/SSB antibodies. Primary outcome was preeclampsia with or without severe features. Secondary outcomes were gestational hypertension, cesarean delivery and spontaneous preterm birth. Categorical variables were compared using Chi-square and Fisher’s exact test. Student t-test or Mann Whitney test were used for continuous variables. Multivariable logistic regression analysis was performed to adjust for confounders (age, obesity, parity, antiphospholipid syndrome, chronic hypertension, pregestational diabetes).

Results:

124 SSA/SSB antibody positive patients were compared to 86 SSA/SSB negative patients. The characteristics and outcomes are presented in Table 1. The incidence of preeclampsia was significantly higher in patients with positive SSA/SSB antibodies compared to those without antibodies (21.0% vs 10.5%, p=0.04). There was no difference in the incidence of gestational hypertension, spontaneous preterm birth or cesarean delivery. After adjusting for confounders, positive SSA/SSB antibodies remained an independent risk factor for preeclampsia (OR 2.66, 95% CI 1.04-6.84, p=0.04).

Conclusion:

In our historic cohort, the presence of SSA/SSB antibodies in patients with autoimmune disease appears associated with an increased incidence of preeclampsia. Additional larger and prospective studies are necessary to further examine this possible association.