Adverse pregnancy outcomes in adolescents and young women with systemic lupus erythematosus: A national estimate
Pediatric Rheumatology Apr 21, 2018
Ling N, et al. - Authors compared the risk of adverse pregnancy outcomes in adolescents and young women with SLE to risk among peers without SLE. An increased risk of adverse, pregnancy-specific outcomes including pre-eclampsia/eclampsia, maternal death, preterm birth, spontaneous abortion, and induced abortion was seen in adolescents and young women with SLE than their peers. Moreover, experts noted the length of stay and total charges for hospitalization to be increased in women with SLE.
Methods
- Researchers studied the 2000-2011 Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) to estimate the prevalence of adverse pregnancy outcomes in women with SLE aged ≤ 21 years at time of delivery.
- They compared the outcomes to peers without SLE by using multivariate logistic regression to calculate odds ratios and risk differences.
- Moreover, they described the differences in length of stay and total charges per hospitalization.
Results
- As per data, there were 8,791,391 unique pregnancies, of which 4,002 occurred in young women with SLE.
- Findings suggested that after adjustment for age, race, insurance type and quartile of median income based on patient ZIP code, individuals with SLE had increased odds of pre-eclampsia/eclampsia (OR 3.2, 95% CI 2.3-4.6), maternal death (OR 80, 95% CI 10-604), preterm birth (OR 2.7, 95% CI 2-3.7), spontaneous abortion (OR 5.1, 95% CI 2.8-9.6), and induced abortion (OR 30, 95% CI 14-63).
- For preterm birth (RD 11%, 95% CI 6–16), pre-eclampsia/eclampsia (RD 9%, 95% CI 5–13), and spontaneous abortion (RD 4%, 95% CI 0.9–6), the increase in risk among women with SLE was greatest.
- Results demonstrated that the risk difference for induced abortion was 2% with 95% CI 0.6-4, whereas, the difference in risk for maternal death did not reach statistical significance (RD 0.4, 95% CI -0.4-1).
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