{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T19:30:27Z","timestamp":1773862227749,"version":"3.50.1"},"reference-count":81,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,16]],"date-time":"2017-09-16T00:00:00Z","timestamp":1505520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>Undifferentiated connective tissue diseases (<jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content>s) are a heterogeneous group of disorders characterized by symptoms and signs suggestive of systemic autoimmune rheumatic disease (<jats:styled-content style=\"fixed-case\">ARD<\/jats:styled-content>), but which do not fulfill all the established criteria for definite diagnosis of a condition. Although a third of <jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content>s can progress to a definite <jats:styled-content style=\"fixed-case\">ARD<\/jats:styled-content> within months or years, most <jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content>s can remain stable for years with minimal disease activity. The annual incidence of <jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content> in the general population ranges from 14 to 140 per 100\u00a0000 people. <jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content>s are associated with the persistence of several circulating autoantibodies including antinuclear, antiphospholipid or antithyroid antibodies. Immunological evaluation of subjects with <jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content>s suggests a proinflammatory state and dysregulation of the Th1\/Th2 balance. Autoantibodies have well\u2010known deleterious effects on placentation and have been associated with an increased risk of prematurity, fetal growth restriction (<jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>), preeclampsia, and congenital atrioventricular heart block. Although epidemiological and biological data suggest a potential negative impact on reproductive outcomes, the relationship between <jats:styled-content style=\"fixed-case\">UCTD<\/jats:styled-content> and pregnancy outcomes has not been adequately studied. While awaiting definitive data from large studies, obstetricians should be aware that rheumatic disorders in their early, incomplete, or undifferentiated phases can adversely affect pregnancy outcomes, increasing the likelihood of pregnancy loss, <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>, preeclampsia, and prematurity.<\/jats:p>","DOI":"10.1111\/aji.12762","type":"journal-article","created":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T14:11:00Z","timestamp":1505743860000},"source":"Crossref","is-referenced-by-count":16,"title":["Undifferentiated connective tissue diseases and adverse pregnancy outcomes. An undervalued association?"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-1084","authenticated-orcid":false,"given":"Arsenio","family":"Spinillo","sequence":"first","affiliation":[{"name":"Division of Obstetrics and Gynecology University of Pavia IRCCS Fondazione Policlinico San Matteo  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausta","family":"Beneventi","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynecology University of Pavia IRCCS Fondazione Policlinico San Matteo  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Caporali","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University of Pavia IRCCS Fondazione Policlinico San Matteo  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronique","family":"Ramoni","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University of Pavia IRCCS Fondazione Policlinico San Matteo  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlomaurizio","family":"Montecucco","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University of Pavia IRCCS Fondazione Policlinico San Matteo  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2015.03.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16154-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-009-0155-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.12.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.07.001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328363ebf7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2011.11.016"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200001)43:1<140::AID-ANR18>3.0.CO;2-P"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2014.00244"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.3964"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kei159"},{"key":"e_1_2_9_13_1","first-page":"1332","article-title":"Early undifferentiated connective tissue disease.I. Early clinical manifestations in a large cohort of patients with undifferentiated connective tissue diseases compared with cohorts of well established connective tissue disease","volume":"18","author":"Alarc\u00f3n GS","year":"1991","journal-title":"J Rheumatol"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.019"},{"key":"e_1_2_9_15_1","first-page":"213","article-title":"Defining unclassifiable connective tissue diseases: incomplete, undifferentiated or both?","volume":"32","author":"Doria A","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-014-8452-9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23018"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.04.004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2014.07.001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2010.02.001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-009-1175-2"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2669"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2010.86"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30155"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.78"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.6"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000199"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-016-3474-7"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-008-0527-6"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01530.x"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.6.485"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38874"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38247"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.104"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22791"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3510"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-05-0416"},{"key":"e_1_2_9_38_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/S0015-0282(16)58382-4","article-title":"Frequency of factors associated with habitual abortion in 197 couples","volume":"66","author":"Stephenson MD","year":"1996","journal-title":"Fertil Steril"},{"key":"e_1_2_9_39_1","first-page":"355","article-title":"Women with inflammatory polyarthritis have babies of lower birth weight","volume":"28","author":"Bowden AP","year":"2001","journal-title":"J Rheumatol"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1191\/0961203302lu187oa"},{"key":"e_1_2_9_41_1","first-page":"180","article-title":"Isolated congenital heart block in undifferentiated connective tissue disease and in primary Sj\u00f6gren's syndrome: a clinical study of 81 pregnancies in 41 patients","volume":"57","author":"Grava C","year":"2005","journal-title":"Reumatismo"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.05.008"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311409610"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1076-8"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.109108"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.041970"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2011.02.006"},{"key":"e_1_2_9_48_1","first-page":"729","article-title":"Soluble Fms\u2010like tyrosine kinase associated with preeclampsia in pregnancy in systemic lupus erythematosus. J Rheumatol. 2008;35:631\u20104. Erratum","volume":"35","author":"Qazi U","year":"2008","journal-title":"J Rheumatol"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.047"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2012.01.006"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2567.2005.02317.x"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/284215"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2015.04.005"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004336"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2016.02.004"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3533-9"},{"key":"e_1_2_9_57_1","first-page":"615","article-title":"Undifferentiated connective tissue diseases (UCTD): a review of the literature and a proposal for preliminary classification criteria","volume":"17","author":"Mosca M","year":"1999","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2012.01.006"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12429"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-3050-7"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203316671814"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu236"},{"key":"e_1_2_9_63_1","first-page":"46","article-title":"Endothelin\u20101 downregulates matrix metalloproteinase 14 and 15 expression in human first trimester trophoblasts via endothelin receptor type B","volume":"32","author":"Majali\u2010Martinez A","year":"2017","journal-title":"Hum Reprod"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1270343"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2013.08.003"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00117.2016"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1057811"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.07.1158"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200108)44:8<1832::AID-ART320>3.0.CO;2-C"},{"key":"e_1_2_9_70_1","first-page":"167","article-title":"Increased risk of complete congenital heart block in infants born to women with hypothyroidism and anti\u2010Ro and\/or anti\u2010La antibodies","volume":"33","author":"Spence D","year":"2006","journal-title":"J Rheumatol"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209770"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.707661"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22159"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.119263"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.88"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-016-2748-0"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000423816.39542.0f"},{"key":"e_1_2_9_78_1","first-page":"151","article-title":"The world incidence and prevalence of autoimmune diseases is increasing","volume":"4","author":"Lerner A","year":"2015","journal-title":"Int J Celiac Dis"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2014.07.016"},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22708"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39737"},{"key":"e_1_2_9_82_1","first-page":"i2172","article-title":"British Society for Rheumatology National Audit, Project Working Group and Steering Committee. Importance of early detection and referral of rheumatoid arthritis","volume":"353","author":"Ledingham JM","year":"2016","journal-title":"BMJ"}],"container-title":["American Journal of Reproductive Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faji.12762","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.12762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T06:20:11Z","timestamp":1695709211000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aji.12762"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,16]]},"references-count":81,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/aji.12762"],"URL":"https:\/\/doi.org\/10.1111\/aji.12762","archive":["Portico"],"relation":{},"ISSN":["1046-7408","1600-0897"],"issn-type":[{"value":"1046-7408","type":"print"},{"value":"1600-0897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,16]]},"article-number":"e12762"}}