FRI0543 BIRTH REGISTRY OF WOMEN WITH SYSTEMATIC LUPUS ERYTHEMATOSUSAND COURSE OF THE DISEASE DURING FIRST YEARS POST-PARTUM-THE GREEK EXPERIENCE. (2nd June 2020) - Ntali, S.
Abstract : Background: Pregnancy in women with SLE Systematic Lupus Erythematosus (SLE) has been related with adverse events both in the mother and the foetus. 1 Many studies have reported relapse of the disease during the pregnancy and post-labour, while others have not confirmed this finding. 2 To this end, most of these results originate from retrospective studies with patients of diverge ethnicities. Objectives: To record the Greek experience with pregnancies in mothers with SLE and their outcomes, as well as the course of the disease during first year post labor. Methods: This is a prospective, multicentre, observation study lasting three years. Women diagnosed with SLE who became pregnant consented to be monitored by their treating Rheumatologist. A structured questionnaire is used for monitoring at the beginning of pregnancy (positive pregnancy test) and at least every 3 months thereafter, depending on the course of the disease and pregnancy, until one year after childbirth. Results: A total 64 women and 81 pregnancies were recorded (1.27 pregnancies per patient). Patient's age at conception was 32.8 ± 5.9 years (mean ± standard deviation). Thirteen patients (20.3%) had past history of nephritis. Regarding pregnancy outcomes, 62 (76.5%) pregnancies ended in live births, miscarriages during 1 st, 2 nd and 3 rd trimester occurred in 13 (16%). Six pregnancies were lost to followup. Prematurity occurred in 28 live births (45.1% in total), 26-32w (3.2%), 32-36w (22.5%), <37w (19.3%). No cases of preeclampsia occurred. Mean age of birth 36.9 weeks and mean birth weight 2750gr. The majority (72.5%) of deliveries were performed by caesarean section. In terms of disease activity, most of the women had mild disease at conception, (SLEDAI-2K: 2.67±2.69) that declined during 1 st /2 nd pregnancy trimester (SLEDAI-2K:1.91±2.09, 1.70±2.22)) but increased during the 1 st and 2 nd trimester post labor (SLEDAI-2K: 2.47±4.29 and 2.52±3.2). Conclusion: This is the first Greek inception cohort with prospective monitoring of pregnant SLE patients. Adverse outcomes occur with prematurity being the most frequent. In our cohort disease activity tends to increase during 1 st and 2 nd trimester post-labor without serious relapses. Vigilant monitoring during pregnancy and post-labour is advised. References: [1] 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. J Autoimmun 2017;79:17-27. [https://doi. org/10.1016/j.jaut.2017.02.009] [PMID: 28256367] [2] Wei S, Lai K, Yang Z, Zeng K. Systemic lupus erythematosus and risk of preterm birth: a systematic review and meta-analysis of observational studies. Lupus 2017;26:563-71. [https://doi. org/10.1177/0961203316686704] [PMID: 28121241] Acknowledgments: Hellenic Rheumatology Association Disclosure of Interests: Stella Ntali: None declared, Lina Pantazi: None declared, Kyriaki Boki: None declared, Dionysis Nikolopoulos: None declared, Antonis Fanouriakis: None declared, Despoina Dimopoulou: None declared, Ioannis Kallitsakis Grant/research support from: MSD, Speakers bureau: Genesis pharma, Bristol-Myers Squibb, CHARALAMPOS PAPAGORAS: None declared, Vasiliki Dania: None declared, Evgenia Emmanouilidou: None declared, George Bertsias Grant/research support from: GSK, Consultant of: Novartis