Predictors of Pregnancy Outcomes in Systemic Lupus Erythematosus Save
A systematic review of preconception predictors of pregnancy outcomes in women with systemic lupus erythematosus (SLE) highlighted lupus nephritis, chronic hypertension, SLE disease activity and secondary antiphospholipid syndrome as predictors of adverse pregnancy outcomes (APO).
Pregnancies in women with SLE have historically been described as challenging, both because of the risk of disease flare and of adverse pregnancy outcomes.
The metanalysis included 72 articles and 10 355 pregnancies (in 8065 SLE women). Predictors of adverse pregnancy outcomes included:
- Previous lupus nephritis
- decreased livebirth probability (OR 0.62 [95% CI 0·47–0·81])
- increased risk of preterm birth (OR 2.00 [1·55–2·57])
- increased risk of pre-eclampsia (OR 3.11 [2·35–4·12])
- Chronic hypertension
- increased risk of disease flare (OR 2.50 [1·74–3·58])
- Increased preterm birth (OR 2·65 [1.87–3·77])
- Increased pre-eclampsia (OR 5·86 [3.41–10·06])
- SLE disease activity (at conception or preconception) - increased risk of preterm birth (OR 2.91 [1·96–4·33]) and pre-eclampsia (OR 2.32 [1·40–3·83])
- Secondary antiphospholipid syndrome
- decreased livebirth probability (OR 0.40 [0·27–0·58])
- increased risk of pregnancy loss after 20 weeks gestation (OR 2.77 [1·44–5·31])
- increased risk of preterm birth (OR 1.65 [1·29–2·11])
Preconception counseling is especially necessary in these instances to insure optimal patient management and pregnancy outcomes.
ADD THE FIRST COMMENT
Disclosures
The author has no conflicts of interest to disclose related to this subject
If you are a health practitioner, you may Login/Register to comment.
Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.