Maternal and fetal outcomes in pregnancies affected by mixed connective tissue disease

Introduction: Mixed connective tissue disease (MCTD) is an autoimmune condition with overlapping features of lupus, systemic sclerosis, and polymyositis. Maternal-fetal outcomes specific to MCTD remain poorly characterized; a scoping review was conducted. Methods: Five databases were queried. Extracted data included demographics, antibody profiles, symptoms, treatments, and maternal-fetal outcomes. Descriptive analysis was performed. Results: Of 269 articles, 33 met inclusion criteria, including 375 pregnancies. Common symptoms and disease manifestations included Raynaud's phenomenon, arthralgias, and sclerodactyly. Treatments included hydroxychloroquine, azathioprine, and corticosteroids. Maternal complications included interstitial lung disease (21.4%), gestational hypertension (HTN) (15.6%), chronic HTN (7.0%), pulmonary HTN (9.8%), eclampsia (1.4%), miscarriage (20.3%), preterm birth (19.6%), and stillbirth (8.1%). Fetal complications included chondrodysplasia punctata (18.2%), demise (6.5%), neonatal lupus erythematosus (3.3%), and congenital heart block (1.0%). Conclusion: While most MCTD pregnancies resulted in live birth, they carry elevated maternal and perinatal risks that warrant heightened surveillance and tailored management.