Pregnancy outcomes before and after a diagnosis of systemic lupus erythematosus

Objective: The purpose of this study was to evaluate pregnancy. outcomes before and after of lupus. design: Study Successive selection criterion applied to 148 lupus and 78,905 non-lupus pregnancies, generated 3 groups: lupus group, 84 pregnancies (not-yet-diagnosed group, 15 women; already-diagnosed group, 69 women), and control group, 51,000 pregnancies. Three-way analysis of variance and the chi-squared test were used for analyses. Results: Stillbirth outcome was increased in the lupus group compared with the control group (odds ratio, 4.84 [95% CI, 1.72,11.08]); the not-yet-diagnosed group (odds ratio, 9.89 [95% Cl, 1.09,42.63]), and the already-diagnosed group (odds ratio, 3.85 [95% Cl, 1.02,10.31]). Considering > 1 pregnancy per patient would have overestimated the stillbirth rate. Stillbirth risk was increased significantly in severe maternal disease that was marked by central nervous system involvement. The already-diagnosed group had more hypertensive complications (P =.001 and.0001). Both lupus groups showed a significantly greater proportion of preterm 3 births (P =.03), growth restriction (P =.019), and infants in the very low birth weight category (P =.021) compared with the control group. Conclusion: Poor fetal outcomes are seen in pregnancies that are complicated by lupus, even before clinical appearance of disease, which supports a predisease state. (C) 2005 Mosby, Inc. All rights reserved.