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  • O7 High incidence of both spontaneous and indicated preterm birth in women with systemic lupus erythematosus: a systematic review and meta-analysis

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O7 High incidence of both spontaneous and indicated preterm birth in women with systemic lupus erythematosus: a systematic review and meta-analysis
  1. Birgit Blomjous1,
  2. Carolien Abheiden2,
  3. Ciska Slaager3,
  4. Anadeijda Landman1,
  5. Johannes Ket4,
  6. Jane Salmon5,
  7. Jill Buyon6,
  8. Martijn Heymans7,
  9. Johanna de Vries2,
  10. Irene Bultink1 and
  11. Marjon de Boer2
  1. 1Dept. of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and immunology Center, Amsterdam institute for Infection and Immunity, Amsterdam University Medical Center, Amsterdam, The Netherlands
  2. 2Dept. of Obstetrics and Gynecology, Amsterdam Reproduction and Development research institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
  3. 3Dept. of Gynecology, Erasmus University Medical Center, Rotterdam, The Netherlands
  4. 4Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  5. 5Hospital for Special Surgery and Weill Cornell Medical College, New York, USA
  6. 6New York University Grossman School of Medicine, New York, USA
  7. 7Dept. of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Center, Amsterdam, The Netherlands

Abstract

Objective Preterm birth (PTB) is a frequent complication of pregnancy in women with systemic lupus erythematosus (SLE). The high indicated PTB rate due to hypertensive disorders of pregnancy and/or fetal growth restriction in women with SLE is well known. Preventive measures are taken and screening for early detection are performed, but the risk of spontaneous PTB is less well recognized. The objective of this study is to determine the rates of both spontaneous and indicated PTB in pregnancies of women with SLE.

Methods A systematic literature search using Pubmed, Embase, Web of Science and Google Scholar was performed in June 2021. Studies on pregnant women with SLE reporting spontaneous and indicated PTB (birth <37 weeks) rates were selected. Original research articles in English published from 1995 to June 2021 were included. Quality and risk of bias of the included studies were assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). To estimate the pooled event rates and 95% confidence intervals, meta-analyses of single proportions with a random-effects model were performed.

Results We included 21 articles, containing data of 8157 ongoing pregnancies in women with SLE. Fifteen out of the 21 included studies were of good quality according to the NOS. From the ongoing pregnancies, 31% (95% CI [0.26; 0.35]) resulted in PTB, of which 46% (95% CI [0.39; 0.54]) were spontaneous, and 53% (95% CI [0.44; 0.61]) were indicated; in 1% the cause of PTB was unknown. The incidence of spontaneous PTB in all pregnancies was 14% (95% CI [0.11; 0.16]) and of indicated PTB 16% (95% CI [0.12; 0.19]).

Conclusion In pregnant women with SLE, spontaneous as well as indicated PTB rates are high. This information should be applied in (pre-pregnancy) counselling and management in pregnancy. The knowledge obtained by this review and meta-analysis paves the way for further research of associated risk factors and development of interventions to reduce spontaneous PTB rate in SLE pregnancies.

Funding None.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.17

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