General Obstetrics and Gynecology: ObstetricsPregnancy outcomes before and after a diagnosis of systemic lupus erythematosus
Section snippets
Material and methods
After approval by our Human Investigation Committee, computerized records of the Wayne State University/Hutzel Hospital Perinatal Database were examined. All women with a diagnosis of lupus who were delivered at our institution over a 101-month period were included in the study. The method of selection of the lupus pregnancies for analysis is shown in the Figure. As indicated, there were 143 pregnancies in 98 women with lupus who were delivered at our institution over the 101-month period (SLE
Results
Results are delineated by the order shown in the Figure, beginning with fetal wastage. In our SLE total group, 82.5% of the pregnancies (118/143) resulted in a live birth, and fetal wastage was 17.5% (25/143 pregnancies). When the SLE TOTAL Group and the SLE first pregnancy group are compared with their respective control groups, there is a reduction of the odds ratio from 6.20 (all pregnancies) to 4.84 (1 pregnancy per parturient) for stillbirths in lupus pregnancies. When stillbirth rates are
Comment
The key finding of our study is that poor fetal outcomes are seen in pregnancies that are complicated by lupus, even before the disease is clinically apparent in the mother. This is a firm conclusion, although we encountered some limitations in our attempt to do a large rigorous study in assessing fetal growth in pregnancies that were complicated by lupus. Unfortunately, we ended up with a smaller sample size than we would have liked, which was necessitated by assuring statistical independence.
Acknowledgment
We thank Dr Sean Blackwell for the compilation and analysis of the control sample data.
References (41)
Pregnancy in SLE
Baillieres Clin Rheumatol
(1998)- et al.
Obstetrical outcome of pregnancy in patients with systemic lupus erythematosus: a study of 60 cases
Eur J Obstet Gynecol Reprod Biol
(1999) - et al.
Pregnancy in lupus nephritis and related disorders
Am J Kidney Dis
(1987) Maternal and fetal complications in pregnant women with systemic lupus erythematosus
Am J Kidney Dis
(1991)- et al.
Lupus pregnancy: case-control prospective study demonstrating absence of lupus exacerbation during or after pregnancy
Am J Med
(1984) - et al.
Pregnancy in patients with systemic lupus erythematosus
Am J Obstet Gynecol
(1983) - et al.
Pregnancy in women with systemic lupus erythematosus
Eur J Obstet Gynecol Reprod Biol
(2002) - et al.
Pregnancy course and complications in patients with systemic lupus erythematosus
Am J Reprod Immunol
(1992) - et al.
Clinical predictors of fetal outcome in systemic lupus erythematosus
J Rheumatol
(1998) - et al.
Systemic lupus erythematosus and pregnancy: a prospective study
Clin Exp Rheumatol
(1992)
Systemic lupus erythematosus and pregnancy
J Rheumatol
Fetal outcome in lupus pregnancy: a retrospective case-control study of 242 pregnancies in 112 patients
Lupus
Fetal outcome of lupus pregnancy: a retrospective case-control study of the Hopkins Lupus Cohort
J Rheumtol
Pregnancy outcome in women with systemic lupus erythematosus
Obstet Gynecol
Systemic lupus erythematosus in pregnancy
Ann Int Med
Outcome of pregnancies in lupus: experience at one center
Ann Med Interne (Paris)
Pregnancy outcome in systemic lupus erythematosus (SLE): a review of 54 cases
Aust N Z J Med
Perinatal outcomes in women with systemic lupus erythematosus
J Perinatol
Epidemiologic study of pregnancy complicated by lupus
Ann Med Interne (Paris)
Lupus nephropathy and pregnancy
Clin Obstet Gynecol
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Supported by the Lupus Alliance of America, Michigan Indiana Chapter (formerly: Lupus Foundation of Michigan); the Michigan Education and Research Foundation (Blue Cross/Blue Shield of Michigan); the Fraternal Order of Eagles: Roseville, Michigan Chapter.