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Pregnancy for patients with lupus has long been considered high risk and associated with both medical and obstetric complications, but outcomes have improved over the last 2 decades and continue to improve. The large decline in in-hospital maternal mortality was greater for lupus pregnancies than for non-lupus pregnancies. Findings from a retrospective cohort study are published in Annals of Internal Medicine.
Researchers examined the the National Inpatient Sample database of hospitalizations of adult pregnant women with and without lupus to assess nationwide trends and disparities in maternal and fetal complications among pregnant women with lupus. They compared An estimated 93 820 pregnant women with SLE and 78 045 054 without SLE were hospitalized in the United States from 1998 through 2015.
Outcomes improved during those 18 years. Regarding in-hospital maternal mortality, lupus patients had greater improvement than those without lupus, with a rate dropping from 34 times higher (442 vs 13 per 100,000) in 1998 to 2000 to less than 5 times higher (<50 vs. 10) in 2013 to 2015.
Fetal mortality rates for SLE patients also declined, but the decrease did not reach statistical significance.
Outcomes in women with lupus in all measures are improving faster with those without lupus.According to the study authors, these findings suggest that lupus pregnancy improvements are significant over the past 18 years.
In this large study examining SLE and non-SLE pregnancies over 18 years, in-hospital maternal mortality and overall outcomes improved markedly, particularly among women with SLE. However, improvement is still needed, because SLE pregnancy risks remain high.