Lupus & antiphospholipid syndrome
Variations of C3 and C4 Before and During Pregnancy in Systemic Lupus Erythematosus: Association With Disease Flares and Obstetric Outcomes
Main finding · Flares during pregnancy, associated with low C4 at preconception (multivariate analysis)Result — go to the resultOdds ratio 13.81 95% CI 3.10–61.43Authors' conclusion
Low C4 at preconception was found to be an independent risk factor for SLE flare during pregnancy.
Study context
- Population
- Systemic lupus erythematosus (SLE) pregnancies followed 1987–2018 in 2 Italian rheumatology centres246 SLE pregnancies in 172 patients
- Participants
- 246 vs 175
- Exposure
- Complement levels in SLE pregnancies vs pregnancy-modified normal ranges from the general obstetric population; pregnancies with vs without flares or obstetric complications
- SLEn = 246
- General obstetric population (GOP)n = 175reference
- Outcome
- Complement (C3, C4) level variations in relation to disease flares and obstetric complications
Methodological detailsprospectively followed pregnancies, retrospectively analysed, 2 Italian rheumatology centres, multivariate analysis
- Prospectively followed pregnancies, retrospectively analysed
- 2 Italian rheumatology centres
- Multivariate analysis
Main finding
As reported in the abstract
Flares during pregnancy, associated with low C4 at preconception (multivariate analysis)
Odds ratio
13.81
95% CI 3.10–61.43
P < 0.001
Low C4 at preconception
OR 13.81 (95% CI 3.10–61.43); P < 0.001
Observational data: associations, not effects.
Further findings
Live births among SLE pregnancies
- Live births
- 89%
SLE flares during pregnancy
- Flares recorded
- 35
- Pregnancies with flares
- 30 (12.2%)
Safety
Obstetric complications in SLE pregnancies
- Pregnancies with obstetric complications
- 47 (19.1%)
- Pregnancy losses
- 27
- Severely preterm births
- 11
- Perinatal deaths (from severely preterm births)
- 2
- Hypertensive disorders
- 15
Original publication
Variations of C3 and C4 Before and During Pregnancy in Systemic Lupus Erythematosus: Association With Disease Flares and Obstetric Outcomes. J Rheumatol. Published 1 May 2023. doi:10.
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