This study aimed to investigate whether obstetric complications before systemic sclerosis (SSc) diagnosis are more common than the general obstetric population. A case controlled study compared prior obstetric complications in adult women who later developed SSc (cases) with women from the general obstetric population who did not develop SSc from the years 2007‐2016. Exposures included past neonatal intensive care unit (NICU) admission, maternal infections, preterm birth, hypertensive disorders of pregnancy (gestational hypertension, eclampsia, preeclampsia), intrauterine growth restriction (IUGR), and premature rupture of membranes (PROM).

Seventeen SSc cases and 170 non‐SSc controls were identified, with median maternal age at delivery 34 years (range 23‐46 years) and the median time from delivery to SSc diagnosis two years (range 0.2‐7.3 years). SSc cases were more likely to be Black and Hispanic. Prior obstetric complications appeared higher in women with an eventual SSc diagnosis compared to controls (70.6% vs. 50%), including hypertensive disorders (17.7% vs. 9.4%), PROM (11.8% vs. 4.1%), IUGR (5.9% vs 1.8%), maternal infection (29.4% vs. 14.1%), NICU admissions (23.5% vs. 7.7%), and preterm delivery (29.4% vs. 21.8%). Cases had higher odds of delivering infants requiring NICU admission (OR=4.7, 95% CI 1.2‐18.8).

In conclusion, women who develop SSc eventually, had an inclination towards more complex pregnancy histories.