A NEW study reveals that cardiovascular events (CVEs) during pregnancy significantly increase the likelihood of adverse outcomes, particularly in individuals with autoimmune rheumatic diseases (ARDs) or primary antiphospholipid syndrome (APS). The findings emphasise the need for specialised care in managing these high-risk pregnancies.
The study analysed data from a California birth cohort spanning 2005 to 2020, encompassing over 7 million pregnancies. Researchers compared CVE rates and their impact on adverse pregnancy outcomes (APOs), such as preterm birth (PTB) and small-for-gestational-age (SGA) infants, across individuals with ARDs, APS, and those without these conditions.
CVEs were more frequent in pregnancies with ARDs (1.4%) and APS (5.5%) compared to those without either condition (0.3%). The presence of CVEs was strongly linked to an increased incidence of APOs. Over 50% of ARD pregnancies complicated by CVEs experienced adverse outcomes, compared to 26.6% without CVEs. CVEs raised the risk of PTB in ARD pregnancies (adjusted risk ratio [aRR]: 1.6) and non-ARD/APS pregnancies (aRR: 1.7) and SGA infants in all groups (aRR: 1.2-1.5).
“These findings underscore the clinical importance of managing cardiovascular health in autoimmune and rheumatic disease pregnancies, where baseline risks for adverse outcomes are already elevated,” the authors noted.
The study highlights the need for multidisciplinary care and early intervention strategies to mitigate risks and improve outcomes for pregnant individuals with ARDs, APS, or other cardiovascular vulnerabilities.
Aleksandra Zurowska, EMJ
Reference
Dhital R et al. Cardiovascular Events During Pregnancy: Implications for Adverse Pregnancy Outcomes in Individuals With Autoimmune and Rheumatic Diseases. J Rheumatol. 2025; 52(1):93-99.
