Background Juvenile-onset systemic lupus erythematosus (JSLE) is characterized by severe organ involvement. Information about pregnancy in these patients is very limited.
Objectives Compare the maternal and fetal outcomes in women with juvenile-onset systemic lupus erythematosus (JSLE) with adult-onset SLE (ASLE).
Methods We retrospectively studied a cohort of pregnant women with SLE (ACR 1997) between January 2005 and August 2013. Patients were assessed in each trimester and postpartum. Two groups were compared, pregnancies in women with JSLE (onset <18 years) and ASLE (onset ≥18 years). Clinical, biochemical and immunological characteristics of women, along with maternal and fetal complications, were recorded. Statistical analysis included descriptive statistics, chi square, Student t test and logistic regression; odds ratios (OR) with confidence intervals (CI) of 95% were calculated. For the analysis each pregnancy was considered as an independent event.
Results We included 186 pregnancies (58 with JSLE and 128 with ASLE) in 180 patients. Women with JSLE were younger at the time of pregnancy (23.5±4.6 vs 28.6±4.8 years, p<0.0001), had a longer history of lupus (9.6±5.4 vs 3.9±3.1 years, p<0.0001) and had a higher frequency of primiparity (63% vs 41.4%, p=0.005), hematologic manifestations (41.4% vs 2.4%, p=0.01), lupus nephritis (55.2% vs 26.6%, p≤0.0001) and positive anticardiolipin antibodies (40% vs 29%, p=0.04). There were no differences in maternal (53.4% vs 47.7%, p=0.46) or fetal complications (48.3% vs 61.7%, p=0.08) in both groups (Table). In the logistic regression analysis, the risk factors for the development of maternal complications were: disease activity before pregnancy (OR 5.4, 95%CI 1.6-18.0, p=0.005) and primiparity (OR 2.5, 95%CI 1.2-5.0, p=0.009); and for fetal complications it was preeclampsia (OR 9.3, 95%CI 1.9-43.7, p=0.05).
Conclusions Although with more severe organic involvement, women with JSLE have maternal and fetal outcomes similar to ASLE.
Silva CAA, et al. J Rheumatol 2008;35:1414-8.
Disclosure of Interest None declared