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Abstract
Background Obstetric morbidity (OM) is higher in Systemic Lupus Erythematosus (SLE) women than in healthy ones. Few data on SLE pregnancy outcomes in Latin America (LA) have been reported. The aim of this study was to assess SLE pregnancy outcomes in LA.
Methods GLADEL 2.0 is an observational prevalent/incident cohort started in 2019.1 To date, 43 centers from 10 LA countries have enrolled 1030 SLE patients, ≥18 years, 1982/1997 ACR or SLICC criteria. Women with at least one pregnancy were included. Past and ongoing (6, 12, 24 months follow-up) OM (miscarriages, fetal deaths, pre-eclampsia, prematurity, neonatal lupus) were evaluated.
Results At inclusion, 329 women have had at least one pregnancy [median (IQR): 2 (1–3)]: table 1. Of them, 293 (89.1%) had ≥1 live birth and 183 (55.6%) developed OM. Pre-eclampsia occurred in 49 (14.9%). Among 71 (21.6%) women with anti-SS-A(Ro)/SS-B(La) antibodies, 3 (4.2%) developed neonatal lupus (without cardiac involvement). Anti-phospholipid syndrome (APS) was associated with a higher risk of pregnancy complications (52.2% vs 10.0%; p< 0.001). Of the 755 pregnancies reported, 551 (73.0%) resulted in live births, of which 79 (14.3%) were premature. The remaining pregnancies ended in 178 (23.6%) miscarriages and 41 (5.4%) fetal deaths. During 2-follow-up years (figure 1), 24 single pregnancies occurred. All occurred under antimalarials; 16 (66.7%) resulted in live births, 4 (25.0%) premature; 12 (50.0%) developed OM. There were seven (29.2%) miscarriages and one fetal loss (4.2%) related to severe pre-eclampsia. One cholestasis gravidarum (4.2%) lead to prematurity. New cases of neonatal lupus were not reported.
Conclusions In GLADEL 2.0 cohort, around half of the women studied presented OM, being frequently related to APS. Miscarriages, prematurity, pre-eclampsia, and fetal deaths were the most common fetal-maternal complications. The incidence of neonatal lupus was lower than previously reported (16%).2
Pregnancy outcome during 2-year follow-up (6, 12 and 24 months
Sociodemographic, clinical and treatment characteristics among SLE women with at least one pregnancy at cohort inclusion related to obstetric morbidity
References
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