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Association Between Raynaud's Phenomenon and Pregnancy Complications [266]

Arnold, Katherine Caldwell MD; White, Dena Elaine MD; Flint, Caroline Jane MD

doi: 10.1097/01.AOG.0000463242.21632.59
Monday, May 4, 2015: PDF Only

INTRODUCTION: Raynaud's phenomenon is caused by vasospasm of the small muscular arteries of the digits. Given this, we hypothesize that pregnant patients with Raynaud's phenomenon experience higher rates of hypertensive disorders and other pregnancy complications associated with placental insufficiency. Consequently, patients may have higher rates of emergent deliveries and poor neonatal outcomes. Anecdotal data support these theories; however, the objective data are lacking. The aim of our study is to elucidate the rates of pregnancy complications in patients with Raynaud's phenomenon.

METHODS: An institutional review board-approved survey was published online with a link to it on the Raynaud's Association web site and their Facebook page. The survey includes 32 questions regarding Raynaud's phenomenon and pregnancy complications. All females with Raynaud's phenomenon were eligible for the survey. Mean and standard deviations were calculated and compared with averages of national data of pregnancy complications using Pearson χ2 tests.

RESULTS: Results (n=110) show that participants experienced infertility at high rates (26%). Twenty one percent reported having hypertensive disorders. Thirty-two percent report having had at least one cesarean delivery and 25% report having had an emergency cesarean delivery. Five percent of participants report having had an abruption with some of their pregnancies. Twenty-seven percent reported preterm deliveries. Seven percent reported three or more miscarriages. Thirty-two percent reported some or all of their neonates were admitted to the neonatal intensive care unit. Two percent of patients report having a pregnancy result in a perinatal death.

CONCLUSION: Patients with Raynaud's phenomenon appear to be at increased risk for vascular complications during pregnancy such as hypertensive disorders, emergent deliveries, and poor neonatal outcomes. Obstetric providers should be aware of their increased risk and manage pregnancies accordingly.

University of Oklahoma Health Science Center, Oklahoma City, OK

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.