Pregnancyoutcomes in systemic lupus erythematosus: data from a multiethnic, multinational latin american cohort
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abstract
Obstetric morbidity (OM) is higher in SLE women than in healthy ones. Few data on SLE pregnancy outcomes in Latin America (LA) have been reported.Objectives To study SLE pregnancy outcomes in LA. Methods GLADEL 2.0 is an observational prevalent/incident cohort started in 2019. To date, 43 centers from 10 LA countries have enrolled 1030 SLE patients (1982/1997 ACR or SLICC criteria). Women with ≥1 pregnancy were included. Past and ongoing (6, 12, 24 months follow-up) OM (miscarriages, fetal deaths, preeclampsia, prematurity, neonatal lupus) were evaluated. Results At inclusion, 329 women have had at least one pregnancy [median (IQR): 2 (1-3)]: Table 1. Of them, 293 (89.1%25) had ≥1 live birth and 183 (55.6%25) developed OM. Preeclampsia occurred in 49 (14.9%25). Among 71 (21.6%25) women with anti-SS-A(Ro)/SS-B(La) antibodies, 3 (4.2%25) developed neonatal lupus (no cardiac involvement). Antiphospholipid syndrome (APS) was associated with higher risk of OM (52.2%25 vs 10.0%25; p< 0.001). Of the 755 pregnancies reported, 551 (73.0%25) resulted in live births, of which 79 (14.3%25) were premature. The remaining pregnancies ended in 178 (23.6%25) miscarriages and 41 (5.4%25) fetal deaths. During 2-follow-up years (Figure 1), 24 singles pregnancies occurred. All were under antimalarials; 16 (66.7%25) resulted in live births, 4 (25.0%25) premature; 12 (50.0%25) developed OM. There were seven (29.2%25) miscarriages and one fetal loss (4.2%25) related to severe preeclampsia. One cholestasis gravidarum (4.2%25) lead to prematurity. There were no new cases of neonatal lupus. Conclusion In GLADEL 2.0 cohort, around half of the studied women presented OM being frequently related to APS. Miscarriages, prematurity, preeclampsia and fetal deaths were the most common pregnancy complications. The incidence of neonatal lupus was lower than previously reported [1].
