AB0424 PREDICTORS OF SLE FLARE-UP AND PREMATURE DELIVERY IN PREGNANCY. (2nd June 2020)

• Record Type: Journal Article
• Authors: Liao, C. H.; Wang, L. C.; Hsieh, S. C.; Chiang, B. L.
• Is Part Of: Annals of the rheumatic diseases. Volume 79(2020)Supplement 1
• Page Start: 1511
• Page End: 1512
• Publication Date: 2020-06-02
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2020-eular.2904
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Systemic lupus erythematosus (SLE) is a life-threatening autoimmune disease that affects many women of child-bearing age, with potentially severe consequences on pregnancy outcome. SLE flare-ups may occur during pregnancy and the post-partum period. Previous studies documenting the incidence and risk factors of flare-up of SLE during pregnancy and puerperium had partially discordant results. Objectives: We aimed to delineate the pregnancy complications of women with SLE, as well as neonatal outcomes of their offspring, and hoped to clarify the incidence and risk factors of SLE flare-ups during pregnancy and puerperium. Methods: We retrospectively reviewed the medical records of SLE patients with previous records of pregnancies in our institution. Flare events during pregnancy and puerperium were documented. The pregnancy outcomes recorded include live births, intra-uterine fetal death (IUFD), premature delivery (< 36 weeks of gestational age), NICU admission, and small for gestational age (SGA, <10 th percentile). Univariate logistic regression was performed to determine the factors associated with disease relapse and pregnancy outcomes. Results: From January, 2000 to December, 2019, a total of 94 SLE patients with 139 pregnancies were identified. The overall live birth rate was 92.4% (134/145). Forty-six (34.3%) of the neonates were delivered prematurely. Forty-six (34.3%) of them were SGA. The admission rate to the neonatal intensive care unit was 25% (30/120). Nine (6.4%) were diagnosed to have SLE during pregnancy. The flare rate during pregnancy was 20% while post-partum 9.4%. The majority of the relapses during pregnancy occurred in the second trimester (46.2%), followed by the first trimester (30.8%), and the third trimester (23.1%). Low complement C3 (C3 < 80mg/dl), thrombocytopenia (PLT < 100*10 3 /uL) at conception, and low serum albumin level at the first trimester were associated with antepartum flare. Presence of disease flare and pre-eclampsia in pregnancy, and low serum albumin level at conception were significantly associated with premature delivery. Conclusion: Low complement C3 and thrombocytopenia at conception, and low serum albumin level at the first trimester were associated with disease flare-up during pregnancy. Patients with relative low serum albumin level at conception, or presence of eclampsia or disease flare-up during pregnancy had a higher risk of premature delivery. References: [1]Shaharir SS, Mohamed Said MS, Mohd R, et al. Predictors of SLE relapse in pregnancy and post-partum among multi-ethnic patients in Malaysia. PloS one 2019;14 (9):e0222343. [2]Bundhun PK, Soogund MZ, Huang F. Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy: A meta-analysis of studies published between years 2001-2016. Journal of autoimmunity 2017;79 :17-27. Disclosure of Interests: None declared