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Preterm Delivery Phenotypes in Systemic Lupus Erythematosus Pregnancies
Stanford Univ, Sch Med, Dept Hlth Res & Policy, Div Epidemiol, HRP Redwood Bldg,Room T152,259 Campus Dr, Stanford, CA 94305 USA;Stanford Univ, Dept Med, Sch Med, Div Rheumatol & Immunol, Stanford, CA 94305 USA;Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden.
Stanford Univ, Dept Med, Sch Med, Div Rheumatol & Immunol, Stanford, CA 94305 USA.
Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden.ORCID iD: 0000-0002-9769-324X
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Obstetrics. Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden.ORCID iD: 0000-0001-6431-3303
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2019 (English)In: American Journal of Perinatology, ISSN 0735-1631, E-ISSN 1098-8785, Vol. 36, no 9, p. 964-968Article in journal (Refereed) Published
Abstract [en]

Objective: Women with systemic lupus erythematosus (SLE) are at a greater risk of preterm delivery, many of which may be medically indicated (iatrogenic). We investigated preterm delivery phenotypes in SLE and general population comparators and assessed the role of preeclampsia.

Study Design: We used population-based Swedish Register data (2001-2013) and defined maternal SLE as >= 2 SLE-coded discharge diagnoses from the Patient Register with >= 1 coded by an appropriate specialist. Women from the general population were identified using the Total Population Register. Preterm delivery was defined as <37 weeks and separated into spontaneous and iatrogenic, as well as later versus extremely preterm (32 to <37 weeks vs. <32 weeks). Maternal comorbidity was assessed, and the proportion mediated by preeclampsia was calculated examining first, subsequent, and all pregnancies.

Results: Preterm delivery was more common in SLE for the first (22 vs. 6%) and subsequent (15 vs. 4%) pregnancies among 781 SLE-exposed pregnancies and 11,271 non-SLE pregnancies. Of SLE-exposed first births, 27% delivered before 32 weeks, and 90% were iatrogenic (compared with 47% of non-SLE first births).

Conclusion: Preterm delivery complicates a greater proportion of SLE pregnancies than general population pregnancies, and a considerable proportion of risk is mediated through preeclampsia.

Place, publisher, year, edition, pages
THIEME MEDICAL PUBL INC , 2019. Vol. 36, no 9, p. 964-968
Keywords [en]
lupus, preterm birth, registers, preeclampsia
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:uu:diva-391949DOI: 10.1055/s-0038-1675648ISI: 000477661000014PubMedID: 30477035OAI: oai:DiVA.org:uu-391949DiVA, id: diva2:1346456
Funder
Swedish Research Council, 2014-3561Available from: 2019-08-28 Created: 2019-08-28 Last updated: 2019-08-28Bibliographically approved

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Wikström, Anna-Karin

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