Women with systemic lupus erythematosus at greater risk of pregnancy complications

USA: A recent study conducted by B. Mehta and the team shows that even in this most recent decade, people with systemic lupus erythematosus (SLE) had a greater incidence of fetal morbidity and severe maternal morbidity. The findings of this study were published in the BMJ journal Annals of the Rheumatic Diseases.

Systemic lupus erythematosus is an autoimmune illness that primarily affects women of reproductive age. This study was carried forward to estimate the proportion of fetal and maternal morbidity in SLE births compared to non-SLE deliveries in a ten-year nationwide study in the United States.

The National Inpatient Sample database was used to identify all delivery-related hospital admissions of patients with and without Systemic Lupus Erythematosus from 2008 to 2017 using ICD-9 (710.0) and 10 (M32*) codes. Preterm birth and intrauterine growth restriction were two markers of fetal morbidity. Using the conventional CDC criteria, 21 signs of severe maternal morbidity were identified: these are unexpected outcomes of labor and delivery that have major short- or long-term effects on a woman's health. Using the dataset's sample weights, descriptive statistics and their 95% confidence intervals were generated.

The key findings of this study were as follows:

1. SLE was recorded in 51,161 individuals (10,297 unweighted) of the 40 million delivery-related hospitalizations.

2. When compared to non-SLE patients, SLE patients were more likely to be older and have more comorbidities.

3. Patients with SLE were more likely to have fetal morbidity, such as intrauterine growth restriction (8.0% vs 2.7%) and premature birth (14.5% vs 7.3%), than patients without SLE.

4. According to the CDC's maternal morbidity indicators, SLE patients had a higher risk of blood transfusion, acute renal failure, puerperal cerebrovascular disorders, cardiovascular and peripheral vascular disorders, eclampsia, or DIC, and general medical concerns than those who did not have SLE.

In conclusion, despite major gains in treatment, new statistics show that maternal mortality and adverse pregnancy morbidity are on the rise in the United States. This research can assist clinicians in discussing and caring for people with SLE during pregnancy and pregnancy planning.

Reference: 

Mehta, B., Glaser, K. K. J., Jannat-Khah, D., Luo, Y., Sammaritano, L., Salmon, J. E., Goodman, S., & Wang, F. (2022). Op0124 fetal and maternal morbidity in pregnant Systemic Lupus Erythematosus (sle) patients: A 10-year u.S. National study. Annals of the Rheumatic Diseases, 81(Suppl 1), 80–81. https://doi.org/10.1136/annrheumdis-2022-eular.3226