Relationship between parity and clinical and biological features in patients with systemic sclerosis

Objective. To assess the influence of parity on the clinical and biological features of systemic sclerosis (SSc). Methods. We recorded the following clinical and biological data of 100 cons ecutive women with SSc: age, disease duration before diagnosis, cutaneous e xtension of sclerosis according to LeRoy's classification, pulmonary involv ement, and antinuclear antibodies. We compared these features to the number and sex of children who were born before Sc onset. Date of birth of the fi rst children was systematically recorded. Results. Patients with limited SSc had more children before SSc onset than patients with diffuse SSc (2.4 +/- 1.8 vs 1.7 +/- 1.5; p < 0.05). The inter val between first birth and SSc onset was shorter for patients with limited SSc than for patients with diffuse SSc (11.0 +/- 9.9 vs 23.5 +/- 14.5 yrs; p < 0.01). Patients with pulmonary fibrosis had more children than patient s without pulmonary fibrosis (2.5 +/- 1.9 vs 2.0 +/- 1.6; p < 0.05). Age at first birth was significantly higher when the child was a girl than a boy (26.8 +/- 7.5 vs 22.9 +/- 5.3 yrs; p < 0.05). The interval between the firs t birth and SSc onset was shorter when the child was a girl than a boy (16. 2 +/- 9.6 vs 25.4 +/- 13.4 yrs; p < 0.05). Conclusion. Pregnancy related microchimerism could be preferentially associ ated with limited SSc and pulmonary fibrosis. Microchimerism may be facilit ated in cases in which the fetus is female.