Organ-specific systemic lupus erythematosus activity during pregnancy is associated with adverse pregnancy outcomes

Sara K. Tedeschi, Hongshu Guan, Alexander Fine, Karen H. Costenbader, Bonnie Bermas

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Systemic lupus erythematosus (SLE) is a disease of reproductive-age women, and thus questions regarding how disease influences pregnancy outcomes arise. We investigated whether five specific types of SLE activity during the 6 months before conception or during pregnancy (nephritis, cytopenias, skin disease, arthritis, serositis) were associated with adverse pregnancy outcomes. We performed a retrospective cohort study of pregnancy outcomes among women with SLE at the Brigham and Women’s Hospital Lupus Center. Adverse pregnancy outcomes included pre-eclampsia, pre-term delivery, elective termination due to SLE, spontaneous miscarriage at weeks 12–20, and stillbirth. SLE and obstetric history, laboratories, and medications were obtained from electronic medical records. Generalized linear mixed models adjusting for potential confounders were used to identify predictors of any adverse pregnancy outcome. Most pregnancies resulted in a live term delivery (76.5 %). After adjustment for Hispanic ethnicity, prior adverse pregnancy outcome and medication use 6 months before conception, nephritis during pregnancy (odds ratio (OR) 3.6, 95 % confidence interval (CI) 1.0–12.8), cytopenias during pregnancy (OR 3.9, 95 % CI 1.3–11.4), and serositis during pregnancy (OR 5.9, 95 % CI 1.0–34.0) were significantly associated with adverse pregnancy outcome. Specific types of SLE disease activity during pregnancy were related to adverse pregnancy outcome. Nephritis, cytopenias, and serositis carried a higher risk of adverse pregnancy outcome, suggesting that these abnormalities should be carefully monitored during pregnancy.

Original languageEnglish (US)
Pages (from-to)1725-1732
Number of pages8
JournalClinical Rheumatology
Volume35
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Pregnancy Outcome
Systemic Lupus Erythematosus
Pregnancy
Serositis
Nephritis
Odds Ratio
Confidence Intervals
High-Risk Pregnancy
Stillbirth
Electronic Health Records
Spontaneous Abortion
Pre-Eclampsia
Hispanic Americans
Skin Diseases
Obstetrics
Arthritis
Linear Models
Cohort Studies
Retrospective Studies
History

Keywords

  • Disease activity
  • Epidemiology
  • SLE

ASJC Scopus subject areas

  • Rheumatology

Cite this

Organ-specific systemic lupus erythematosus activity during pregnancy is associated with adverse pregnancy outcomes. / Tedeschi, Sara K.; Guan, Hongshu; Fine, Alexander; Costenbader, Karen H.; Bermas, Bonnie.

In: Clinical Rheumatology, Vol. 35, No. 7, 01.07.2016, p. 1725-1732.

Research output: Contribution to journalArticle

Tedeschi, Sara K. ; Guan, Hongshu ; Fine, Alexander ; Costenbader, Karen H. ; Bermas, Bonnie. / Organ-specific systemic lupus erythematosus activity during pregnancy is associated with adverse pregnancy outcomes. In: Clinical Rheumatology. 2016 ; Vol. 35, No. 7. pp. 1725-1732.
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