Systemic sclerosis (SSc; scleroderma) is an uncommon illness with an annual incidence of 1 to 2 per 100,000 individuals in the United States [1,2]. The peak onset is between the ages of 30 and 50. (See "Overview of the clinical manifestations of systemic sclerosis (scleroderma) in adults".)
As of 1971, only 12 cases of pregnancy in women with SSc had been reported. Mortality among these patients was alarmingly high: four patients died (three from renal and pulmonary disease and one from a postpartum viral infection) . The incidence of pregnancy in women with SSc is increasing since a greater number of women are choosing to have children later in life.
This topic will review issues of fertility and pregnancy outcome among patients with SSc, as well as the impact of pregnancy upon disease activity.
It is difficult to draw any clear conclusions concerning fertility in women with SSc. In the 1950s, women with SSc were thought to have diminished fertility because of the low incidence of pregnancy in those with preexisting disease . However, subsequent studies showed mixed results with respect to pregnancy rates and to the frequency of pregnancy difficulties among women with SSc, both prior to and after the diagnosis.
The following findings were noted in different observational studies of women with SSc who were of child-bearing age: