Tuesday, 07 Apr 2020

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Pregnancies are Adversely Affected Even Before the Diagnosis of Lupus

Arkema and colleagues assessed maternal and fetal outcomes in patients with SLE, pre-clinical (prior to onset) SLE and prevalent maternal SLE during pregnancy compared with the general population. These cohorts were identified from a population-based Swedish registry that included 13,598 women with first pregnancies and compared 551 prevalent SLE, 65 pre-SLE (within 0-2 years), 133 pre-SLE (within 2-5 years), and 12,847 general population controls. (Citation source http://buff.ly/1TmInbe)

SLE patients were more likely to have preeclampsia, hypothyroid disease, stroke, and infection. Preeclampsia was 3-fold higher (16%) in prevalent SLE pregnancies compared with 5% from the general population. This trend was also seen in those with pre-SLE, wherein preeclampsia was seen in 26% of those with pre-SLE within 2 years post-partum and 13% for 2-5 years post-partum.

Infant outcomes were also worse, including pre-term birth, infection, and infant mortality, in mothers with prevalent SLE and pre-SLE during pregnancy.

This study showed that both adverse maternal and fetal outcomes are more common in SLE pregnancies. In addition, they are also prevalent in the years prior to a diagnosis of SLE. Thus, the underlying immunologic profile of SLE and alterations preceding clinical SLE may contribute to these pregnancy complications. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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