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Preterm Delivery Phenotypes in Systemic Lupus Erythematosus Pregnancies
Julia F Simard1,2,3, Yashaar Chaichian2, Marios Rossides3
1Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
American Journal of Perinatology
|November 27, 2018
Summary
Women with systemic lupus erythematosus (SLE) face higher risks of preterm birth, often medically indicated. Preeclampsia significantly contributes to this increased risk in SLE pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Rheumatology
- Perinatal Medicine
Background:
- Systemic lupus erythematosus (SLE) in pregnant women increases the risk of adverse pregnancy outcomes.
- Preterm delivery is a significant concern, with a notable proportion being iatrogenic (medically indicated).
Purpose of the Study:
- To investigate preterm delivery phenotypes in women with SLE compared to the general population.
- To assess the role of preeclampsia in mediating preterm delivery risk in SLE pregnancies.
Main Methods:
- Utilized Swedish Register data (2001-2013) for population-based analysis.
- Defined maternal SLE and compared preterm delivery rates (<37 weeks) between SLE-exposed and non-SLE pregnancies.
- Differentiated between spontaneous and iatrogenic, and extremely preterm (<32 weeks) versus later preterm deliveries, analyzing the impact of preeclampsia.
Main Results:
- Preterm delivery was significantly more common in SLE pregnancies (22% first, 15% subsequent) versus general population (6% first, 4% subsequent).
- Among SLE first births, 27% were extremely preterm, with 90% being iatrogenic.
- Preeclampsia was identified as a significant mediator of preterm delivery risk in SLE.
Conclusions:
- Women with SLE experience a higher incidence of preterm delivery compared to the general population.
- A substantial portion of the increased preterm delivery risk in SLE is attributable to preeclampsia.
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