Lupus & antiphospholipid syndrome
Pregnancy outcome predictors in systemic lupus erythematosus: a systematic review and meta-analysis
Authors' conclusion
We identified previous lupus nephritis, chronic hypertension, SLE disease activity before and at conception, and secondary antiphospholipid syndrome as predictors of adverse pregnancy outcomes in women with SLE.
Study context
- Population
- Pregnant women with systemic lupus erythematosus (SLE); studies from PubMed and Embase from inception to Aug 22, 2023
- Participants
- 8,065 women72 studies10,355 pregnancies
- Comparison
- Preconception predictors vs their absence
- Outcome
- Preconception predictors of pregnancy outcomes:
- Livebirth
- Pre-eclampsia
- Small for gestational age
- Preterm birth
- Pregnancy loss before and after 20 weeks
- SLE flares
Methodological detailsrandom effects model, pooled univariate odds ratios (ORs), PROSPERO-registered, One potentially eligible study was retracted and removed, Risk-of-bias assessment suggested considerable bias in study attrition and confounding
- Random effects model
- Pooled univariate ORs
- PROSPERO-registered
- One potentially eligible study was retracted and removed
- Risk-of-bias assessment suggested considerable bias in study attrition and confounding
Pooled result
As reported in the abstract
Predictors of adverse pregnancy outcomes, pooled univariate OR
Estimate (95% CI)
Previous LNI2=0%
OR, livebirth 0.62(0.47–0.81)
Previous LNI2=17%
OR, preterm birth 2.00(1.55–2.57)
Previous LNI2=0%
OR, pre-eclampsia 3.11(2.35–4.12)
Chronic hypertensionI2=0%
OR, disease flare 2.50(1.74–3.58)
Chronic hypertensionI2=0%
OR, preterm birth 2.65(1.87–3.77)
Chronic hypertensionI2=33%
OR, pre-eclampsia 5.86(3.41–10.06)
SLE disease activityI2=21%
OR, preterm birth 2.91(1.96–4.33)
SLE disease activityI2=0%
OR, pre-eclampsia 2.32(1.40–3.83)
Secondary APSI2=0%
OR, livebirth 0.40(0.27–0.58)
Secondary APSI2=0%
OR, pregnancy loss after 20 weeks 2.77(1.44–5.31)
Secondary APSI2=0%
OR, preterm birth 1.65(1.29–2.11)
Original publication
Pregnancy outcome predictors in systemic lupus erythematosus: a systematic review and meta-analysis. Lancet Rheumatol. Published 14 August 2024. doi:10.
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