Lupus & antiphospholipid syndrome
Impact of pregnancy on organ damage in systemic lupus erythematosus: a multicentre study
Authors' conclusion
In women with predominantly well-controlled SLE, short-term organ damage accrual during pregnancy and the early postpartum period was uncommon. Pre-existing damage was associated with further accrual, while baseline disease activity also emerged as associated in the sensitivity analysis; however, the small number of events limits conclusions regarding other potential risk factors.
Study context
- Population
- Women fulfilling SLE classification criteria with complete damage assessments from 2 years before conception to 1 year after conceptionpregnancies included
- Participants
- 165 pregnancies
- Comparison
- Within-patient SDI changes during the pregnancy/early postpartum period compared with the pre-pregnancy reference period
- Outcome
- Disease flares during pregnancy
- Follow-up
- During pregnancy
Methodological detailstwo tertiary referral centres with dedicated pregnancy clinics, within-patient comparison with the pre-pregnancy reference period
- Two tertiary referral centres with dedicated pregnancy clinics
- Within-patient comparison with the pre-pregnancy reference period
Main finding
As reported in the abstract
Experienced disease flares, predominantly mild to moderate
20.6%
Further findings
Damage progression by pre-existing damage
| OR (95% CI) | ||
|---|---|---|
| Pre-existing damage | 6.77 (1.43–32.05) | |
| 0.050.21520Odds ratio (log scale) |
Cumulative damage (SDI) · one year before conception to one year after conception
- Mean SDI one year before conception
- 0.18±0.43
- Mean SDI one year after conception
- 0.22±0.52
- Mean ΔSDI
- 0.04±0.21
- Median change
- zero
New damage
- Pregnancies with new damage, limited to a single SDI item
- seven pregnancies (4.2%; 95% CI 2.1% to 8.5%)
Frequency of progression restricted to a single pregnancy per woman
- Progression
- 6/126, 4.8%
- Sensitivity analysis
Other factors (disease activity at conception, flare-ups, obstetric complications, treatments)
- Inconclusive
Baseline disease activity and damage progression (sensitivity analysis)
- Rank-biserial r
- −0.55; 95% CI −0.78 to −0.27, p=0.030
- Sensitivity analysis; association with pre-existing damage confirmed
Original publication
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