Pregnant Women With Systemic Lupus Erythematosus at Higher Risk of Complications

Systemic lupus erythematosus (SLE) may be related to a greater risk of pregnancy complications, according to a study published in the International Journal of Women’s Health.

The researchers completed a 2-sample Mendelian randomization (MR) analysis using genome-wide association studies of SLE and pregnancy complications and outcomes. Data for the MR analysis were derived from a large meta-analysis of genome-wide association studies of patients in Europe, as well as from the FinnGen research project data set. The findings from the 2-sample MR analysis were validated through a retrospective analysis of 200 pregnant women with SLE compared with a control group of pregnant women without SLE who delivered at Tongji Hospital in Wuhan, China.

In the MR analysis, they found that individuals with a genetic susceptibility to SLE had a higher risk of developing gestational diabetes mellitus (odds ratio [OR], 1.028; 95% CI, 1.006-1.050). Susceptibility to SLE was also associated with a greater risk of premature delivery (OR, 1.039; 95% CI, 1.013-1.066), polyhydramnios (OR,1.075; 95% CI, 1.004-1.151), and premature rupture of membranes (OR, 1.030; 95% CI, 1.001-1.060).

Validation with the retrospective cohort showed alignment on several findings from the MR analysis, such as an increased risk of gestational diabetes mellitus and preterm birth. In this cohort, the ORs for gestational diabetes and preterm birth were 1.861 (95% CI, 1.074-3.142) and 2.550 (95% CI, 1.251-5.005), respectively. The MR analysis did not find a causal relationship between SLE and an increased risk of preeclampsia/eclampsia; however, there was a higher likelihood of developing this condition among pregnant women with SLE in the retrospective cohort (OR, 2.935; 95% CI, 1.118-7.620).

“Although the current medical technology allows most patients with SLE to have successful pregnancies, all SLE pregnancies should be considered ‘high risk’ due to potential maternal and fetal complications,” the authors wrote in their conclusion. They called for further cohort studies to strengthen their findings and future research to clarify the mechanisms of the impact of SLE on pregnancy complications and outcomes.