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Their rates of spontaneous losses are comparable to the general population, except for patients with late diffuse systemic sclerosis and severe internal organ involvement who may have higher risks of abortion. Prematurity is clearly higher among systemic sclerosis women, similarly to other rheumatic diseases such as systemic lupus erythematosus and anti-phospholipid antibody syndrome. A placental vasculopathy has been observed in some women with systemic sclerosis. Overall, the disease generally remains stable in most pregnancies. Women with pulmonary hypertension should avoid pregnancy on account of the high maternal mortality risk. Management of systemic sclerosis patients before and during pregnancy includes evaluation of organ involvement and autoantibody analysis, preconceptional folic acid, and discontinuation of drugs with teratogenic potential (bosentan, mycophenolate mofetil, methotrexate, etc.). Management by high-risk pregnancy teams including neonatologists is very important to ensure the best outcomes.<\/jats:p>","DOI":"10.1177\/2397198317747440","type":"journal-article","created":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T01:24:41Z","timestamp":1522891481000},"page":"21-29","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Pregnancy in systemic sclerosis"],"prefix":"10.1136","volume":"3","author":[{"given":"Mauro","family":"Betelli","sequence":"first","affiliation":[{"name":"Internal Medicine, Bolognini Hospital, Bergamo - Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Breda","sequence":"additional","affiliation":[{"name":"Internal Medicine, Papa Giovanni XXIII Hospital, Bergamo - Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Ramoni","sequence":"additional","affiliation":[{"name":"Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia - Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Parisi","sequence":"additional","affiliation":[{"name":"Internal Medicine, Papa Giovanni XXIII Hospital, Bergamo - Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Rampello","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, Papa Giovanni XXIII Hospital, Bergamo - Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Limonta","sequence":"additional","affiliation":[{"name":"Rheumatology, Papa Giovanni XXIII Hospital, Bergamo - Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Meroni","sequence":"additional","affiliation":[{"name":"Rheumatology, University of Genoa and A.O.S.S. 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