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Review
Outcomes of pregnancy and associated factors in sub-Saharan African women with systemic lupus erythematosus: a scoping review
  1. Mickael Essouma1,
  2. Jan René Nkeck1,
  3. Kodoume Motolouze2,
  4. Jean Joel Bigna3,
  5. Paul Tchaptchet1,
  6. Grâce Anita Nkoro4,
  7. Stéphane Ralandison5 and
  8. Eric Hachulla6
  1. 1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
  2. 2Department of Gynecology and Obstetrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
  3. 3Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaoundé, Cameroon
  4. 4Dermatology Unit, Yaoundé Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon
  5. 5Department of Internal Medicine and Division of Rheumatology, Faculty of Medicine of Toamasina, Tamatave, Madagascar
  6. 6Department of Internal Medicine and Clinical Immunology, CHU and Univerisity of Lille, Lille, France
  1. Correspondence to Dr Mickael Essouma; essmic{at}rocketmail.com

Abstract

Objective To scope and summarise available literature on the outcomes of pregnancy and associated factors in sub-Saharan African women with SLE.

Methods Electronic databases and reference lists of retrieved articles were searched to identify relevant studies published from 1 January 2000 to 28 October 2019. Data were combined through narrative synthesis.

Results We included four studies retrospectively reporting a total of 137 pregnancies in 102 women over a 26-year period. Mean age at conception ranged from 27.2 to 39.9 years. Kidney damage, the predominant organ manifestation before conception, was reported in 43 (42.2%) patients. Ninety-seven (70.8%) pregnancies resulted in 98 live births. SLE flares occurred in 44 (32.2%) pregnancies, mainly skin (20.4%) and renal (18.2%) flares. Major adverse pregnancy outcomes (APOs) were preterm birth 38.8%, low birth weight 29.8%, pregnancy loss 29.2% and pre-eclampsia 24.8%. The main factors associated with APOs were nephritis and SLE flares.

Conclusion Over two-thirds of pregnancies resulted in live birth in this cohort of sub-Saharan African women with SLE. The main APOs and associated factors described in other parts of the world are also seen in this region, but with high rates of APOs. A large prospective multinational study is warranted for more compelling evidence.

  • lupus erythematosus
  • systemic and outcome assessment
  • qualitative research
  • health care
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-2020-000400

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    Footnotes

    • Presented at the 12th European Lupus Meeting, March 2020 Poster presentation P78, published in Lupus Science and Medicine, March 2020, Vol 7, suppl 1, doi: 10.1136/lupus-2020-eurolupus.123

    • Contributors Conception and design: ME, JJB. Search strategy conception and application: ME, JJB. Study selection: ME, JRN. Data extraction: ME, KM, PT. Data synthesis and analysis: ME. Manuscript drafting: ME. Manuscript revision: GAN, SR, EH, JJB, JRN, KM, PT. All authors approved this document. ME is the guarantor of the review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.