Pregnancy in sjogren's syndrome, mixed connective tissue disease, and undifferentiated connective tissue disease

Sjogren's syndrome (SS), mixed connective tissue disease (MCTD), and undifferentiated connective tissue disease (UCTD) are less common disorders than systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA), but like SLE and RA, these disorders have a higher incidence in women. Sjogren's syndrome predominately impacts women in their later reproductive years. Because of the older age distribution in Sjogren's and the relative rarity of MCTD and UCTD, there is little published information on pregnancy outcome or on impact of pregnancy on maternal disease. In general, these disorders appear to have minimal adverse effects on patients' reproductive potential. Fertility is maintained. Although those with increased disease activity in MCTD are at higher risk for certain pregnancy complications, patients whose disease is under control at conception generally do well. Pregnancy does not appear to contribute to disease activity in Sjogren's or MCTD. Based on limited data, pregnancy may cause patients with UCTD to evolve into more classical connective tissue disorders such as RA or SLE: this low but finite risk should be discussed. The general approach used in the management of other pregnant rheumatic disease patients should be utilized for these patients: pregnancies should be planned, disease activity should be minimized for 6 months prior to pregnancy, and patients should be well controlled on medications compatible with pregnancy.