Pregnancy outcomes between pregnant systemic lupus erythematosus patients with clinical remission and those with low disease activity: A comparative study
- PMID: 36589601
- PMCID: PMC9791546
- DOI: 10.46497/ArchRheumatol.2022.9140
Pregnancy outcomes between pregnant systemic lupus erythematosus patients with clinical remission and those with low disease activity: A comparative study
Abstract
Objectives: This study aims to compare pregnancy outcomes between systemic lupus erythematosus (SLE) patients who attained clinical remission based on the Definition of Remission in SLE (DORIS) and those with lupus low disease activity based on Low Lupus Disease Activity State (LLDAS).
Patients and methods: Between January 1993 and June 2017, a total of 90 pregnancies (one twin pregnancy) from 77 patients (mean age: 26.9±4.8 years; range, 17.9 to 37.3 years) were included in the study. The clinical remission and the LLDAS groups were modified into modified clinical remission and LLDAS groups, respectively by omitting Physician Global Assessment (PGA). The clinical SLE disease activity index (cSLEDAI) score was used for LLDAS.
Results: Pregnancies in 49 patients occurred, when they were in modified clinical remission and in 57 in modified LLDAS. There was no significant difference in demographic characteristics, disease activity, or medication received at conception between the two groups. Pregnancy outcomes were similar between the modified clinical remission and the modified LLDAS groups in terms of successful pregnancy (83.67% vs. 84.21%), full-term births (38.78% vs. 38.60%), fetal losses (16.33% vs. 15.79%), spontaneous abortions (14.29% vs. 14.04%), small for gestational age infants (18.37% vs. 19.30%), low birth weight infants (42.86% vs. 40.35%), maternal complications (46.94% vs. 49.12%), and maternal flares (36.73% vs. 40.35%). The agreement of pregnancy outcomes was very high between the two groups (91.11% agreement).
Conclusion: Pregnancy outcomes in SLE patients who achieved modified clinical remission and modified LLDAS were comparable.
Keywords: Low disease activity; pregnancy; pregnancy outcome; remission; systemic lupus erythematosus..
Copyright © 2022, Turkish League Against Rheumatism.
Conflict of interest statement
Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
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References
-
- Andreoli L, Bertsias GK, Agmon-Levin N, Brown S, Cervera R, Costedoat-Chalumeau N, et al. EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/ or antiphospholipid syndrome. Ann Rheum Dis. 2017;76:476–485. - PMC - PubMed
-
- Bundhun PK, Soogund MZ, Huang F. Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy: A meta-analysis of studies published between years 2001-2016. J Autoimmun. 2017;79:17–27. - PubMed
-
- Chen YJ, Chang JC, Lai EL, Liao TL, Chen HH, Hung WT, et al. Maternal and perinatal outcomes of pregnancies in systemic lupus erythematosus: A nationwide population-based study. Semin Arthritis Rheum. 2020;50:451–457. - PubMed
-
- Lateef A, Petri M. Systemic lupus erythematosus and pregnancy. Rheum Dis Clin North Am. 2017;43:215–226. - PubMed
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