• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Have Pregnancy Risks Improved for Women with Lupus?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • While pregnant women with systemic lupus erythematosus (SLE) have better perinatal outcomes now than in the past, recent trends regarding other outcomes such preeclampsia rates are unknown
  • Mehta et al. (Annals of Internal Medicine, 2019) examined nationwide trends in maternal and fetal complications among pregnant women with SLE

METHODS:

  • Retrospective cohort study (1998 to 2015)
    • National Inpatient Sample (NIS) database (sponsored by the AHRQ and the Healthcare Cost and Utilization Project)
  • Participants
    • Pregnant women admitted to hospital
    • With and without SLE
  • Data analysis
    • Covariate data included co-morbidities, patient demographics, hospital characteristics and region
    • Trends were assessed to look at outcomes over time
  • Primary outcomes: Temporal trends for the following
    • In-hospital maternal mortality and fetal mortality
    • Preeclampsia or eclampsia
    • Cesarean sections
    • Non–delivery-related admissions
    • Length of stay (LOS)

RESULTS:

  • 93,820 pregnant women with SLE | 78,045,054 without SLE
  • In-hospital maternal deaths (per 100,000 admissions) declined among patients both with and without SLE
    • With SLE
      • 1998 to 2000: 442 maternal deaths
      • 2013 to 2015: <50 maternal deaths
    • Without SLE
      • 1998 to 2000: 13 maternal deaths
      • 2013 to 2015: 10 maternal deaths
    • Decrease ‘dramatic’ in women with SLE (difference in trends, P < 0.002)
  • Fetal mortality rate declined among patients both with and without SLE
    • With SLE
      • 1998 to 2000: 268 deaths per 10,000 deliveries
      • 2013 to 2015: 153 deaths per 10,000 deliveries
    • Without SLE
      • 1998 to 2000: 72 deaths per 10,000 deliveries
      • 2013 to 2015 66 deaths per 10,000 deliveries
    • Difference in trends was not statistically significant
  • Preeclampsia or eclampsia rates
    • Decrease with SLE (9.5% to 9.1%) | Increase without SLE 3.3% to 4.1%)
  • C-section rates
    • Increase with SLE (34.0% to 40.7%) | Increase without SLE (21.2% to 31.7%)
  • Hospital LOS
    • Decrease with SLE (mean, 4.3 to 3.8 days) | Increase without SLE (mean, 2.5 to 2.7 days)

CONCLUSION:

  • Authors acknowledge study limitations including
    • Information on hospital-specific trends, SLE disease activity, and medications were not available
    • Race trends could not be analyzed
    • Incidence of outcomes reported may not be exact
  • Overall conclusions
    • In-hospital maternal mortality and overall outcomes have improved for pregnant women with SLE
  • Risks of complications for women with SLE have significantly improved but still remain higher than those for women without SLE

Learn More – Primary Sources:

Trends in Maternal and Fetal Outcomes Among Pregnant Women With Systemic Lupus Erythematosus in the United States: A Cross-sectional Analysis

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

Learn More »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Maternal Near-Misses: An Investigation of Incidence and Causes
Pregnancy-Related Deaths in the U.S.: How Many are Preventable?
Practical obstetrics info for your women's healthcare practice
The Spectrum of Fetal Arrhythmias – From a Common Finding to a Serious Concern
The CMQCC Toolkit: Venous Thromboembolism Prevention and Management at Delivery

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Download Your ObG App
HERE!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site