Pregnancy

Women are affected by systemic sclerosis (SSc) five times more frequently than men and are often diagnosed in their forties, during or soon after their reproductive years. Previously, most women would have completed their pregnancies prior to this age, but more recently, women are frequently delaying pregnancy. Thus, there is an increased likelihood for a concurrent pregnancy in women who develop SSc early in their adult life. The interrelationships of SSc and pregnancy are important with respect to both the effects of SSc on pregnancy and the effects pregnancy may have on underlying maternal SSc. This chapter reviews the literature relating to fertility, pregnancy, and pregnancy outcomes in women with SSc. The management of these high-risk pregnancies, the effects of pregnancy on SSc manifestations, and recommendations for managing medications in the pregnant SSc patient will be discussed. The use of this information in planned, well-supervised pregnancies should increase the likelihood of successful outcomes for both the infant and mother.