ResearchObstetricsA national study of the complications of lupus in pregnancy
Section snippets
Materials and Methods
The research protocol used in this study was reviewed and approved by the Duke University Medical Center Institutional Review Board. The NIS, from the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ), was queried for all pregnancy-related discharge codes for the years 2000-2003. The NIS contains data from approximately 1000 hospitals and is the largest all-payer inpatient care database in the United States. It is a 20% stratified sample
Results
There were more than 16.7 million deliveries between 2000 and 2003: 13,555 of which were to women with a diagnosis of SLE. These pregnancies resulted in 18.3 million pregnancy-related hospitalizations: 17,263 of which were to women with a diagnosis of SLE.
The demographic make-up of the SLE pregnancies was different from the non-SLE pregnant population (Table 1). Women with SLE were, on average, older than women without SLE. A larger proportion of SLE pregnancies were to African American women,
Comment
When compared with other women, SLE patients are at increased risk for maternal death, preeclampsia, preterm labor, thrombosis, infection, and hematologic complications during pregnancy. These elevated risks make clear the need for close monitoring by both maternal-fetal medicine physicians and rheumatologists during pregnancy.
Women with SLE in the NIS cohort had several demographic and medical risk factors for adverse pregnancy outcomes, beyond the diagnosis of SLE. Women with SLE were older
References (25)
- et al.
Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality
Am J Obstet Gynecol
(2006) - et al.
Obstetrical outcome of pregnancy in patients with systemic lupus erythematosus: a study of 60 cases
Eur J Obstet Gynecol Reprod Biol
(1999) Hopkins Lupus Pregnancy Center: 1987 to 1996
Rheum Dis Clin North Am
(1997)- et al.
Decrease in pregnancy loss rates in patients with systemic lupus erythematosus over a 40-year period
J Rheumatol
(2005) Overview of the Nationwide Inpatient Sample (NIS) 2000
(2002)Introduction to the Nationwide Inpatient Sample (NIS) 2002
(2004)- et al.
Incidence and risk factors for stroke in pregnancy and the puerperium
Obstet Gynecol
(2005) - et al.
Acute myocardial infarction in pregnancy: a United States population-based study
Circulation
(2006) - et al.
A national estimate of the elective primary cesarean delivery rate
Obstet Gynecol
(2005) - et al.
Racial differences in cesareans: an analysis of U.S. 2001 National Inpatient Sample Data
Obstet Gynecol
(2005)
Risk factors for coronary heart disease in women with systemic lupus erythematosus: the Toronto Risk Factor Study
Arthritis Rheum
Pulmonary hypertension in systemic lupus
Lupus
Cited by (386)
Fever of unknown origin in pregnancy: A case report
2024, Case Reports in Women's HealthMendelian randomization reveals systemic lupus erythematosus and rheumatoid arthritis and risk of adverse pregnancy outcomes
2024, European Journal of Obstetrics and Gynecology and Reproductive BiologyUpdates on the dermatopathology of pregnancy-associated skin conditions
2023, Human PathologyTemporal trends in adverse pregnancy outcomes in axial spondyloarthritis in Sweden: a cohort study
2023, The Lancet RheumatologySociety for Maternal-Fetal Medicine Consult Series #64: Systemic lupus erythematosus in pregnancy
2023, American Journal of Obstetrics and Gynecology
Cite this article as: Clowse MEB, Jamison M, Myers E, et al. A national study of the complications of lupus in pregnancy. Am J Obstet Gynecol 2008;199:127.e1-127.e6.
Drs Clowse and James are funded by NIH grant 5K12-HD-043446