BackgroundAntiphospholipid antibodies (APLAs) have been associated with pregnancy loss and other obstetric complications, such as pre-eclampsia, fetal growth restriction and preterm delivery.ObjectivesThe purpose of this work is to evaluate maternal and fetal pregnancy outcome in Primary Antiphospholipid Syndrome (PAPS).MethodsWe retrospectively studied PAPS patients according to Sydney Criteria who are attended to Materno Neonatal Hospital during the last 8 years. We evaluated demographic, obstetric and thrombotic clinical data. Maternal complications were evaluated: Preeclampsia, HELLP, Gestational Diabetes, Premature rupture of fetal membranes, arterial and venous thrombosis, mortality, the way of end of pregnancy, and others. Fetal outcome was evaluated as live birth, gestational age and weight at birth.Results96 pregnancies in 68 patients were included. Maternal mean age was 30,75 years old, 84% were from Cόrdoba city, 70.5% did not have health insurance, and they have mean previous pregnancies of 4 with 1 live birth. Maternal complications were: Pre eclampsia in 12 patients (12.5%), Preterm delivery in 6 patients (6.25%), Premature rupture of fetal membranes in 8 (8.33%), Gestational Diabetes in 7 (7.29%), Arterial Thrombosis in 2 (2.08%), Venous thrombosis in 3 (3.12%). 33,69% have normal labour and 66,33% cesarean section. 86% of patients have live birth with mean gestational age of 36 weeks with mean weight at birth of 2.558 g and 73% of patients according to gestational age.Table 1.Maternal ComplicationsPre Eclampsia12 (12,5%)Pre term delivery6 (6,2%)Premature rupture of fetal membranes8 (8,2%)Gestacional Diabetes7 (7,3%)Arterial Thrombosis2 (2%)Venous Thrombosis3 (3,1%)Notch10 (10%)Mortality0ConclusionsPAPS pregnancies patients had a good maternal and fetal outcome in this study.References Bertolaccini ML, Sanna G2 Recent advances in understanding antiphospholipid syndrome. F1000Res. 2016 Dec 22;5:2908. doi: 10.12688/f1000research.9717.1. eCollection 2016.Pelusa HF, Pezzarini E, Basiglio CL, Musuruana J, Bearzotti M, Svetaz MJ, Daniele SM, Bottai H, Arriaga SM. Antiphospholipid and antioangiogenic activity in females with recurrent miscarriage and antiphospholipid syndrome.Ann Clin Biochem. 2016 Sep 16. pii: 0004563216672248. [Epub ahead of print.Moroni G, Doria A, Giglio E, Tani C, Zen M, Strigini F, Zaina B, Tincani A, de Liso F, Matinato C, Grossi C, Gatto M, Castellana P, Limardo M, Meroni PL, Messa P, Ravani P, Mosca M. Fetal outcome and recommendations of pregnancies in lupus nephritis in the 21st century. A prospective multicenter study.J Autoimmun. 2016 Nov;74:6–12. doi: 10.1016/j.jaut.2016.07.010. Epub 2016 Aug 2. AcknowledgementsWe are grateful whit Secyt subsidy UNC.Disclosure of InterestNone declared

BackgroundNeonatal lupus (NL) is a disease in children of mothers who have specific anti-Ro/La IgG autoantibodies by passive transplacental transfer. LN is characterized by skin and cardiac involvement, as well as cytopenias, hepatic or neurological manifestations. NL can be diagnosed intra-uterus or in neonatal period, being self-limiting in several months or be irreversible. Congenital heart block (CHB) in a structurally normal heart, is perhaps the most serious manifestation with an estimated mortality rate of around 19%. Objetives: to estimate the frequency of NL in children of mothers with anti-Ro/La in reference centers in the management of pregnancy and autoimmune diseases in Argentina, and to describe maternal and children features.MethodsA descriptive multicenter study was conducted in reference centers in the management of autoimmune diseases and pregnancy in Argentina. Inclusion criteria were the presence of positive maternal serology anti-Ro/La and at least one pregnancy. Demographic and maternal-fetal clinical data were obtained from the clinical histories and each center completed a data collection form created for this study. We defined a NL case (born or not) who presented, pre and/or postpartum, characteristic skin lesions, cytopenias, cardiac involvement (CHB, endocardial fibroelastosis and dilated cardiomyopathy), hepatic or neurological manifestations. Ethnicity was classified using GLADEL groups. NL frequency was calculated dividing the number NL cases by the number of mothers with positive anti-Ro/La serology.Results18 reference centers in the management of autoimmune diseases and pregnancy participated in this study in 7 different geographic areas of Argentina (6 of Buenos Aires, 6 of Cordoba, 1 of Jujuy, 1 of Mendoza, 1 of Santa Fe, 1 of Santiago del Estero and 2 of Tucuman). 193 mothers with positive anti-Ro/La serology were included with 364 pregnancies. 19 cases NL cases were reported (10 diagnosed during pregnancy and 9 in post-partum. The frequency of NL was estimated at 9.8% [95% CI 6.3–14.9] (CHB=6.2% [IC95% 3.5–10.7]). Table 1 describes the maternal and fetal characteristics of NL cases. The most frequent manifestations were skin (n=7) and cardiac involvement (n=12). In 1 case, there was a history of NL in a previous pregnancy. Of the patients with CHB, 5 required a pacemaker.Abstract 271 Table 1Maternal and fetal characteristics of the 19 NL casesConclusionsIn conclusion, the frequency of NL in our multicentric cohort is greater than other international cohorts. Differences could be related to genetic/environmental factors as well as methodological limitations and selection bias.Funding Source(s):None

BackgroundSystemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women during their reproductive years. The presence of Lupus nephritis (LN) may result in an increased risk of disease flare and adverse maternal and fetal outcomes, such as preeclampsia, fetal loss, and preterm deliveryObjectivesThe purpose of this work is to evaluate pregnancy outcome in SLE patients with previous diagnosis of LN.MethodsWe retrospectively studied SLE patients according 1997 ACR criteria with previous diagnosis of LN by renal biopsy who attended to Materno Neonatal Hospital during the last 5 years. We evaluated demographic, clinical, laboratory and obstetric data. Renal biopsies were classified according ISN/RNP 2004. Lupus activity was evaluated by modified pregnancy SELENA SLEDAI score at the conception and during pregnancy. Maternal complications were evaluated: Preeclampsia, HELLP, Gestational Diabetes, Premature Rupture of the membranes, arterial and venous thrombosis, and others. Fetal outcome was evaluated as live birth, gestational age and weight at birth.Results44 pregnancies in 32 patients were included. Maternal mean age was 22,68 years old, mean duration SLE was 7.8 years and 22% had antiphospholipid syndrome (APS), 62.5% were from Cόrdoba city, 84.3% did not have health insurance, and they have mean previous pregnancies of 2 with 1 live birth. Maternal complications were: Pre eclampsia in 22.7% of patients, Preterm delivery in 20.45% of patients, Premature rupture of the membranes in 6.8%, Gestational Diabetes in 2.27% of patients. 14 patients had normal labour, 29 cesarean section and 1 abortion. 97% (n=42) of patiens have live birth with mean gestational age of 36 weeks with mean weight at birth of 2.399 g. and there was no maternal mortality.Table 1.Maternal ComplicationsPreeclampsia10 (22,7%)Pre term delivery9 (20,4%)Premature rupture of the membranes3 (6,8%)Gestacional diabetes1 (2,3%)Mortality0Renal relapse8 (18,1)Renal Insufficiency2 (4,5%)ConclusionsSLE patients with previous LN had a good maternal and fetal outcome in this study.References Moroni G, Doria A, Giglio E, Tani C, Zen M, Strigini F, Zaina B, Tincani A, de Liso F, Matinato C, Grossi C, Gatto M, Castellana P, Limardo M, Meroni PL, Messa P, Ravani P, Mosca M. Fetal outcome and recommendations of pregnancies in lupus nephritis in the 21st century. A prospective multicenter study. J Autoimmun. 2016 Nov;74:6–12. doi: 10.1016/j.jaut.2016.07.010. Epub 2016 Aug 2.Lazzaroni MG, Dall'Ara F, Fredi M, Nalli C, Reggia R, Lojacono A, Ramazzotto F, Zatti S, Andreoli L, Tincani A. A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus. J Autoimmun. 2016 Nov;74:106–117. doi: 10.1016/j.jaut.2016.06.016. Epub 2016 Jul 2.Moroni G, Doria A, Giglio E, Imbasciati E, Tani C, Zen M, Strigini F, Zaina B, Tincani A, Gatto M, de Liso F, Grossi C, Meroni PL, Cabiddu G, Messa P, Ravani P, Mosca M. Maternal outcome in pregnant women with lupus nephritis. A prospective multicenter study. J Autoimmun. 2016...