{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:33:33Z","timestamp":1787978013790,"version":"build-2784847793"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Mixed connective tissue disease (MCTD) predominantly affects women in their reproductive age (30\u201340 years). This study is aimed to analyze a case series of MCTD-complicated pregnancies. The study design utilized a combined case-series and case\u2013control approach. Pregnant women with MCTD were included and categorized into two groups: the live-birth and non-live birth (encompassing miscarriages at &lt;12 weeks and stillbirths at \u226512 weeks) groups. Primary outcomes included delivery outcomes and factors associated with live births. A total of 57 pregnancies from 34 mothers (median age: 33.0 years) were included. Regarding delivery outcomes, the rates for live birth, miscarriage, and stillbirth were 64.9, 29.8, and 5.3%, respectively. Additionally, the respective rates of preterm delivery, fetal growth restriction (FGR), and small-for-gestational-age (SGA) were 18.9, 18.9, and 27.0%. Higher steroid usage (62.2 vs. 30.0%, <jats:italic>p<\/jats:italic> = 0.02) and lower prednisolone dosage in the live birth group (median dose: 7 vs. 10 mg, <jats:italic>p<\/jats:italic> = 0.03) were found to be significant factors contributing to live births. MCTD during pregnancy was associated with increased risks of miscarriage, stillbirth, preterm delivery, FGR, and SGA. Notably, low-dose steroid therapy was identified as a contributing factor to successful live births.<\/jats:p>","DOI":"10.1371\/journal.pone.0303318","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T18:42:42Z","timestamp":1733424162000},"page":"e0303318","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pregnancy with mixed connective tissue disease: Exploration of factors influencing live birth outcomes"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0290-6952","authenticated-orcid":true,"given":"Tsukasa","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumire","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Matsushita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuo","family":"Itakura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"pone.0303318.ref001","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/0002-9343(72)90064-2","article-title":"Mixed connective tissue disease\u2014an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA)","volume":"52","author":"GC Sharp","year":"1972","journal-title":"Am J Med"},{"key":"pone.0303318.ref002","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1093\/rheumatology\/kes430","article-title":"Prevalence of pulmonary hypertension in an unselected, mixed connective tissue disease cohort: results of a nationwide, Norwegian cross-sectional multicentre study and review of current literature","volume":"52","author":"R Gunnarsson","year":"2013","journal-title":"Rheumatology"},{"key":"pone.0303318.ref003","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s12016-007-0012-0","article-title":"Pulmonary hypertension, antiphospholipid antibodies, and syndromes","volume":"32","author":"RA Asherson","year":"2007","journal-title":"Clin Rev Allergy Immunol"},{"key":"pone.0303318.ref004","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/j.autrev.2017.07.013","article-title":"Clinical and pathologic implications of extending the spectrum of maternal autoantibodies reactive with ribonucleoproteins associated with cutaneous and now cardiac neonatal lupus from SSA\/Ro and SSB\/La to U1RNP","volume":"16","author":"PM Izmirly","year":"2017","journal-title":"Autoimmun Rev"},{"key":"pone.0303318.ref005","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1093\/rheumatology\/kez141","article-title":"Pregnancy outcomes in mixed connective tissue disease: a multicentre study","volume":"58","author":"M Radin","year":"2019","journal-title":"Rheumatology"},{"key":"pone.0303318.ref006","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1038\/s41584-021-00668-1","article-title":"Global epidemiology of systemic lupus erythematosus","volume":"17","author":"MRW Barber","year":"2021","journal-title":"Nat Rev Rheumatol"},{"key":"pone.0303318.ref007","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/14397595.2019.1709944","article-title":"2019 Diagnostic criteria for mixed connective tissue disease (MCTD): From the Japan research committee of the ministry of health, labor, and welfare for systemic autoimmune diseases","volume":"31","author":"Y Tanaka","year":"2021","journal-title":"Mod Rheumatol"},{"key":"pone.0303318.ref008","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1002\/art.1780400928","article-title":"Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus","volume":"40","author":"MC Hochberg","year":"1997","journal-title":"Arthritis Rheum"},{"key":"pone.0303318.ref009","doi-asserted-by":"crossref","first-page":"eabf3041","DOI":"10.1126\/science.abf3041","article-title":"Single-cell eQTL mapping identifies cell type-specific genetic control of autoimmune disease","volume":"376","author":"S Yazar","year":"2022","journal-title":"Science"},{"key":"pone.0303318.ref010","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u201cEZR\u201d for medical statistics","volume":"48","author":"Y. 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