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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. 

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

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