Risk factors associated with infections in pregnant women with systemic lupus erythematosus

The aim of this study was to analyze the occurrence and risk factors associated with infections during pregnancy in patients with systemic lupus erythematosus.

This is a retrospective cohort study using the data of pregnant women who were followed up between 2011 and 2018 at a university hospital.

The data of 221 pregnant women with systemic lupus erythematosus were analyzed. The incidence of infections was 22.6% (50/221), with the urinary tract being the most frequent site of infection (32/221, 14.5%) followed by the respiratory tract (15/221, 6.8%). The bivariate analysis showed that active disease, hematological systemic lupus erythematosus, reduced complement, and use of prednisone ≥5 and ≥10 mg increased the chance of infection during early pregnancy (p=0.05, p=0.04, p=0.003, p=0.008, and p=0.02, respectively), while disease activity and anti-DNA positivity increased it at the end of pregnancy (p=0.03 and p=0.04, respectively). Prednisone at a dose ≥5 mg increased the chance of infection in the beginning (p=0.01) and at the end of pregnancy (p=0.008). Multivariate analysis showed that increasing the dose of prednisone from 5 to 10 mg tripled the chance of developing infections in pregnant women with lupus (p=0.02).

The study showed an increased chance of infections in pregnant women with systemic lupus erythematosus and it was associated with the use of prednisone.