Background In general, pregnancy and delivery complications are more frequently observed in first pregnancy1. Most previous studies have not distinguished between first and subsequent births in analyses of pregnancy outcomes in SLE.
Objectives To examine outcomes in first and subsequent births separately, in women with SLE versus references.
Methods Women diagnosed with SLE according to International Classification of Diseases (ICD-10) and registered in the Medical Birth Registry of Norway (MBRN) formed the exposed group. Reference deliveries were all other deliveries 1999 – 2009 excluding mothers with any inflammatory rheumatic disease. Data for single births were stratified and analyzed in first and subsequent births. First birth was the first delivery of nulliparous women for patients and references. SGA (newborn small for gestational age) was defined as birth weight < 10 percentile for expected birth weight for gestational age. Birth defects included serious malformations in any organ system according to a definition by MBRN based on ICD-10. Perinatal mortality included stillbirths (≥22 weeks of gestation) and early neonatal deaths (0-6 days in live born children). Associations between SLE and adverse perinatal outcomes were assessed in logistic regression analyses with adjustment for maternal age at delivery.
Results Mean age at first delivery in SLE patients and references was 29,4 and 27,7 years, respectively (p<0.001). In subsequent births mean age at delivery in SLE women was 33.0 versus 31,5 years in references (p<0,001). Smoking habits were not statistically significantly different between the groups.
Conclusions We observed a higher risk of low birth weight, preterm delivery, transfer to NICU, perinatal deaths and congenital malformations among the newborn of the patients. The greatest differences between groups were observed in the first pregnancy, and an increased risk of perinatal mortality among children of patients was only observed in first pregnancy. Our observations indicate that special attention should be given to first pregnancy in SLE patients.
References: Cunningham FD, MacDonaldPC et al. Williams Obstetrics. 20 ed. Stamford, Connecticut, USA:1997
Acknowledgements The Medical Birth Registry of Norway (data delivery) The Liaison Committee between the Central Norway Regional Health Authority and NTNU (financial support)
Disclosure of Interest: None Declared