Systemic Lupus Erythematosus Linked to More Adverse Pregnancy Outcomes For Mother, Baby

Pregnant women with systemic lupus erythematosus (SLE) carry higher risks for adverse maternal and fetus outcomes according to a recent study.

The study, “What to Expect When Expecting With Systemic Lupus Erythematosus (SLE): A Population-Based Study of Maternal and Fetal Outcomes in SLE and Pre-SLE,” was published in the journal Arthritis Care & Research.

For the study, researchers investigated the outcomes for both mother and baby associated with SLE. Specifically, they focused on subclinical SLE, defined here as pre-SLE; SLE presenting up to 5 years postpartum (after childbirth); and cases of prevalent maternal SLE occurring during pregnancy. Researchers compared the outcomes in SLE with those of the general population.

To perform the prospective cohort study, the team of researchers used registries from a Swedish patient population. Participants included 13,598 women with first singleton pregnancies (pregnancies that included only one fetus). From the group, 551 women had prevalent SLE; 65 had pre-SLE within 0-2 years; 133 were pre-SLE within 2-5 years; and 12,847 women belonged to the general population.

SLE in the study was defined as having at least two SLE-coded discharge diagnoses in the patient register with one or more diagnosis from a specialist.

The team found women with SLE were more prone to suffer unfavorable maternal outcomes that included preeclampsia (characterized by high blood pressure and signs of damage to another organ system, often the kidneys); hypothyroidism (condition when the body lacks sufficient thyroid hormone); stroke, and infection. From the group, researchers noted preeclampsia in 16% of prevalent-SLE pregnancies, but only 5% in women from the general population.

Among pre-SLE women, researchers detected preeclampsia in 26% of those with SLE within 2 years postpartum and 13% in those with SLE within 2-5 years postpartum

Infants born from mothers with prevalent SLE and pre-SLE during pregnancy also showed more adverse outcomes, such as premature birth, infection, and mortality.

The research concluded that pregnant women with SLE, and their babies, are at higher risk for complications. Most important, the study authors highlighted that adverse outcomes were observed in pregnant women before they were diagnosed with SLE. The observation suggests that SLE altered immune systems before clinical SLE, could be crucial contributors to pregnancy complications.