Meta-analysis Reveals Numerous Pregnancy Complications Associated with Lupus Save

On the heels of the recently published EULAR recommendations for the management of pregnancy in patients with systemic lupus erythematosus (SLE) and the anti-phospholipid syndrome (APS) comes a new meta-analysis published in the Journal of Autoimmunity on pregnancy outomes in lupus.

This systematic review was performed to show the impact of SLE on maternal and fetal outcomes following pregnancy.

Researchers identified 11 studies with 529,778 participants. Key findings included:

• Cesarean operation were significantly higher in SLE (RR: 1.85, 95% CI: 1.63-2.10; P = 0.00001).
• Pre-eclampsia and hypertension also significantly affected women with SLE, (RR: 1.91, 95% CI: 1.44-2.53; P = 0.00001) and (RR: 1.99, 95% CI: 1.54-2.56; P = 0.00001) respectively.
• Spontaneous abortion, thromboembolic disease, and post-partum infection were also significantly higher in the SLE subgroup (RR: 1.51, 11.29, and 4.35, respectively).
• Live birth significantly favored infants who were born from mothers without SLE (RR: 1.38, 95% CI: 1.14-1.67; P = 0.001).
• Significantly higher premature birth and infants classified as 'small for gestational age' were associated with SLE, (RR: 3.05, 95% CI: 2.56-3.63; P = 0.00001) and (RR: 1.69, 95% CI: 1.53-1.88; P = 0.00001) respectively.
• NICU use was significantly associated SLE infants and infants with congenital defects (RR: 2.76, 95% CI: 2.27-3.35; P = 0.00001) and (RR: 2.63, 95% CI: 1.93-3.58; P = 0.00001) respectively.

SLE indeed has a high impact on maternal and fetal outcomes following pregnancy. Guidelines like those proposed by EULAR and being worked on by the ACR will benefit those who care for such patients.