Chronic Damage Not Affected by Pregnancy in Systemic Lupus Erythematosus

Chronic damage related to systemic lupus erythematosus (SLE) was not found to be affected by pregnancy, according to study results published in Lupus.

For this nested case-control analysis, the data of 104 women of childbearing age with SLE from a lupus registry were examined. Disease activity was assessed using the SLE Disease Activity Index, and chronic damage was evaluated using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). The primary outcome of the study was the presence of chronic damage defined as SDI of ≥1. Patients with chronic damage (n=33) were matched with participants without chronic damage (n=33), according to age and disease duration for a nested case-control analysis. Pregnancies, treatment status, and characteristics of patients and control participants were compared.

Of 104 participants, 22 and 13 became pregnant before and after SLE diagnosis, respectively. Among patients for whom the pregnancy outcome could be confirmed, 82% and 50% of the pregnancies that occurred before and after SLE diagnosis, respectively, resulted in live births. Chronic damage was identified in 11 (50%) and 4 (33%) patients with a pregnancy occurring before and after SLE diagnosis, respectively. An additional 26 patients (38%) did not have pregnancies. Pregnancy rates were comparable between patients and control participants before SLE diagnosis (9 vs 8, respectively) and after SLE diagnosis (3 vs 5, respectively).

Hypertension was reported more frequently among patients with chronic damage vs those without chronic damage (48% vs 24%, respectively; P =.041). After adjusting for hypertension, the occurrence of pregnancy before or after a SLE diagnosis was not found to predict chronic damage (odds ratio [OR], 1.48 [95% CI, 0.33-6.65; P =.60] and OR, 0.78 [95% CI, 0.13-4.74; P =.78], respectively).

Limitations included the study’s cross-sectional design.

“Our results may help alleviate fears regarding childbearing in female patients with SLE and their families,” noted the study authors.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference      

Morishita M, Sada KE, Ohashi K, et al. Damage accrual related to pregnancies before and after diagnosis of system lupus erythematosus: a cross-sectional and nested case-control analysis from a lupus registry [published online January 10, 2020]. Lupus. doi:10.1177/0961203319898766