Preterm Delivery Phenotypes in Systemic Lupus Erythematosus Pregnancies

Simard, Julia F.Stanford Univ, Sch Med, Dept Hlth Res & Policy, Div Epidemiol, HRP Redwood Bldg,Room T152,259 Campus Dr, Stanford, CA 94305 USA;Stanford Univ, Dept Med, Sch Med, Div Rheumatol & Immunol, Stanford, CA 94305 USA;Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden (författare)

Objective: Women with systemic lupus erythematosus (SLE) are at a greater risk of preterm delivery, many of which may be medically indicated (iatrogenic). We investigated preterm delivery phenotypes in SLE and general population comparators and assessed the role of preeclampsia.Study Design: We used population-based Swedish Register data (2001-2013) and defined maternal SLE as >= 2 SLE-coded discharge diagnoses from the Patient Register with >= 1 coded by an appropriate specialist. Women from the general population were identified using the Total Population Register. Preterm delivery was defined as <37 weeks and separated into spontaneous and iatrogenic, as well as later versus extremely preterm (32 to <37 weeks vs. <32 weeks). Maternal comorbidity was assessed, and the proportion mediated by preeclampsia was calculated examining first, subsequent, and all pregnancies.Results: Preterm delivery was more common in SLE for the first (22 vs. 6%) and subsequent (15 vs. 4%) pregnancies among 781 SLE-exposed pregnancies and 11,271 non-SLE pregnancies. Of SLE-exposed first births, 27% delivered before 32 weeks, and 90% were iatrogenic (compared with 47% of non-SLE first births).Conclusion: Preterm delivery complicates a greater proportion of SLE pregnancies than general population pregnancies, and a considerable proportion of risk is mediated through preeclampsia.

Chaichian, YashaarStanford Univ, Dept Med, Sch Med, Div Rheumatol & Immunol, Stanford, CA 94305 USA (författare)
Rossides, MariosKarolinska Institutet (författare)
Wikström, Anna-Karin,1965-Karolinska Institutet,Uppsala universitet,Klinisk obstetrik,Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden(Swepub:uu)annwi179 (författare)
Shaw, Gary M.Stanford Univ, Dept Pediat, Div Neonatol & Dev Med, Stanford, CA 94305 USA (författare)
Druzin, Maurice L.Stanford Univ, Dept Obstet & Gynecol, Stanford, CA 94305 USA (författare)
Stanford Univ, Sch Med, Dept Hlth Res & Policy, Div Epidemiol, HRP Redwood Bldg,Room T152,259 Campus Dr, Stanford, CA 94305 USA;Stanford Univ, Dept Med, Sch Med, Div Rheumatol & Immunol, Stanford, CA 94305 USA;Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, SwedenStanford Univ, Dept Med, Sch Med, Div Rheumatol & Immunol, Stanford, CA 94305 USA (creator_code:org_t)

Ingår i:American Journal of Perinatology: THIEME MEDICAL PUBL INC36:9, s. 964-9680735-16311098-8785

Av författaren/redakt...: Simard, Julia F.; Chaichian, Yasha ...; Rossides, Marios; Wikström, Anna-K ...; Shaw, Gary M.; Druzin, Maurice ...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Reumatologi och ...

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