Pregnancy Outcomes in SLE vs Other Connective Tissue, Inflammatory Rheumatic Conditions

The following article features coverage from ACR 2017 in San Diego, California. Click here to read more of Rheumatology Advisor‘s conference coverage.

SAN DIEGO — Mothers with systemic lupus erythematosus (SLE) and other connective tissue diseases have overall low rates of adverse pregnancy outcomes that are nonetheless higher than the rate of adverse pregnancy outcomes for women with other inflammatory rheumatic diseases, according to research presented here at the 2017 ACR/ARHP,Annual Meeting, held Nov. 3-8.

In an observational cohort study, pregnant patients <20 gestational weeks with diagnosed inflammatory rheumatic diseases were enrolled. Patient factors, pregnancy outcomes, and postnatal outcomes up to 2 years after birth were evaluated and compared between women with SLE (n=104), other inflammatory rheumatic diseases (n=271), or other connective tissue diseases (n=77).

The live birth rate was lower for SLE (88.9%) compared with other connective tissue diseases (94.7%) and other inflammatory rheumatic diseases (95.4%).

Preterm birth was higher for mothers with SLE (25%) compared with other connective tissue diseases (16.7%) and other inflammatory diseases (16.3%). Preeclampsia was more common in other connective tissue diseases (10.5%) compared with SLE (4.4%) and other inflammatory diseases (0%). Serious infections occurred in 6 infants, all of whom had mothers with SLE or other connective tissue diseases.

Disease activity at enrollment was highest for patients with other inflammatory rheumatic diseases (physician’s global assessment, 2.5±2.1) and lowest in SLE (physician’s global assessment, 1.6±1.5). More women with SLE received hydroxychloroquine (63%) compared with those with other connective tissue diseases (50%) or other inflammatory rheumatic diseases (5%). Overall, approximately 80% of pregnancies in the study were planned.

The researchers concluded that the “real world data show that although most patients with SLE or [other connective tissue diseases] have a successful outcome of pregnancy, compared to patients with [other inflammatory rheumatic diseases], substantial more adverse pregnancy outcomes occurred.”

Disclosures: Dr Schneider reports relationships with Protagen AG. Dr Richter reports relationships with UCB Pharma GmbH. Dr Zink reports relationships with AbbVie, BMS, MSD, Pfizer, Roche, and UCB. Dr Strangfeld reports relationships with BMS, MSD, Pfizer, Roche, and Sanofi-Aventis.

Visit Rheumatology Advisor’s conference section for continuous coverage from ACR 2017.

Reference

Fischer-Betz R, Bungartz C, Schneider M, et al. Pregnancy outcome in patients with SLE compared to patients with other inflammatory rheumatic diseases: real world data from a prospective pregnancy register. Presented at: 2017 ACR/ARHP Annual Meeting; November 3-8, 2017; San Diego, CA. Poster 1295.