Effect And Follow-up Study Of Drugs For Rheumatic Immune Diseases On Pregnancy Women

Objective: To investigate the current situation of drug use in patients with rheumatic immune diseases during pregnancy,and to follow up the pregnancy outcome and newborns,which can provide reasonable drug use basis for patients who use the drug in preparation and pregnancy in the future,then guide safe pregnancy,reduce the occurrence of adverse maternal and infant outcomes.Methods:(1)From April 2019 to December 2020,the subjects were the consultation group of pregnant patients with rheumatic immune diseases who were exposed to medication in the multidisciplinary immune-related pregnancy clinic and the outpatient department of Sichuan Provincial People’s Hospital.And these patients were also registered and followed up by the “drug registration follow-up form”.(2)Based on the first part of the registration and follow-up,we first made an overall statistics of all the drugs exposed during pregnancy,then made a further discussion on the dosage of drugs for rheumatic immune diseases,and evaluated the safety of drug use in the study population.Finally,the effects of different drug treatments against phospholipid syndrome on pregnancy outcome and neonatal outcome were analyzed.(3)The healthy pregnant women in the same period were randomly matched as the control group,followed up to have pregnancy outcome,and the basic information,pregnancy outcome,newborn condition and antenatal examination of the two groups were collected and analyzed.Results: A total of 87 pregnant women with rheumatic immune diseases were included in this study,with an average of 7 drugs,and the four most frequently used drugs were progesterone,adrenocortical hormone,antiplatelet drug and antimalarial drug(hydroxychloroquine).Univariate analysis showed that age,history of adverse pregnancy,number of pregnancies,total number of pregnancies,history of drug allergy and other diseases did not affect the use of high-risk drugs in patients(P > 0.05),but the mode of pregnancy and reproductive history of patients were influenced by univariate analysis.and the difference is statistically significant.The incidence of gestational diabetes mellitus,gestational hypertension,live birth and premature delivery were 14.63%,7.32%,90.24% and 15.79%,respectively.According to the univariate analysis of different pregnancy outcomes and newborns,it was found that compared with the group aged 30 and above,the incidence of pregnancy loss was higher in the group aged 29 and below.In addition,there was no significant difference in the incidence of pregnancy loss and premature birth in pregnant patients with rheumatic immune disease drug exposure compared with healthy controls;but in the antenatal examination,it was found that there were significant differences in non-invasive DNA examination,Down’s screening abnormality,fetal system ultrasound abnormality and fetal heart ultrasound abnormality between the two groups(P < 0.05).Conclusion: Based on limited research results,drug exposure in pregnancy with rheumatic immune diseases has no effect on adverse pregnancy outcomes and the risk of neonatal outcomes.Most of the patients in the study have rheumatic immune diseases,have a history of bad pregnancy and no fertility,and even some patients who have conceived by assisted reproduction are more likely to be exposed to high-risk drugs.