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Objective: The purpose of this study was to evaluate pregnancy outcomes before and after diagnosis of lupus. Study design: Successive selection criterion applied to 148 lupus and 78,905 non-lupus pregnancies, generated 3 groups: lupus group, 84 pregnancies (not-yet-diagnosed group, 15 women; already-diagnosed group, 69 women), and control group, 51,000 pregnancies. Three-way analysis of variance and the chisquared test were used for analyses. Results: Stillbirth outcome was increased in the lupus group compared with the control group (odds ratio, 4.84 95%CI, 1.72,11.08 ); the not-yet-diagnosed group (odds ratio, 9.89 95%CI, 1.09,42.63 ), and the already-diagnosed group (odds ratio, 3.85 95%CI, 1.02,10.31 ). Considering >1 pregnancy per patient would have overestimated the stillbirth rate. Stillbirth risk was increased significantly in severe maternal disease that was marked by central nervous system involvement. The already-diagnosed group had more hypertensive complications (P = .001 and .0001). Both lupus groups showed a significantly greater proportion of preterm births (P = .03),growth restriction (P = .019), and infants in the very low birth weight category (P = .021) compared with the control group. Conclusion: Poor fetal outcomes are seen in pregnancies that are complicated by lupus, even before clinical appearance of disease, which supports a predisease state.
Objective: The purpose of this study was to evaluate pregnancy outcomes before and after diagnosis of lupus. Study design: Successive selection criterion applied to 148 lupus and 78,905 non-lupus pregnancies, generated 3 groups: lupus group, 84 pregnancies (not-yet- already-diagnosed group, 69 women), and control group, 51,000 pregnancies. Three-way analysis of variance and the chisquared test were used for analyzes. Results: Stillbirth outcome was increased in the lupus group compared with the the odds ratio (4.84 95% CI, 1.72,11.08); the not-yet-diagnosed group (odds ratio, 9.89 95% CI, 1.09,42.63) and the already- diagnosed group (odds ratio, 3.85 95% CI, 1.02, 10.31). Considering> 1 pregnancy per patient would have overestimated the stillbirth rate. Stillbirth risk was increased significantly severe maternal disease that was marked by central nervous system involvement. The already-diagnosed group had more hypertensive complications (P = .001 and .0001). Both lupus groups showed a significantly greater proportion of preterm births (P = .03), growth restriction (P = .019), and infants in the very low birth weight category (P = .021) compared with the control group. Conclusion: Poor fetal outcomes are seen in pregnancies that are complicated by lupus, even before clinical appearance of disease, which supports a predisease state.