Pregnancy rates and perinatal outcomes in women with systemic lupus erythematosus: data from the Korean national health
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ORIGINAL ARTICLE
Pregnancy rates and perinatal outcomes in women with systemic lupus erythematosus: data from the Korean national health claims database Young Bin Joo 1 & Ki-Jo Kim 1 & Kyung-Su Park 1 & Yune-Jung Park 1 Received: 3 June 2020 / Revised: 31 October 2020 / Accepted: 2 November 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Introduction/Objectives The pregnancy rate in systemic lupus erythematosus (SLE) is not fully understood and comparisons of adverse pregnancy outcomes (APOs) with SLE versus the general population are limited. This study aimed to estimate the pregnancy rate and APOs in Korean SLE compared to those without SLE. Method Pregnant women were identified using the ICD-10 codes for delivery and abortion in the Korean national health claims database (2013–2015). APOs were classified as fetal loss, intrauterine growth retardation (IUGR), pre-eclampsia/eclampsia, and gestational diabetes. Annual incidence rates (IRs) of pregnancy and APOs were calculated in women with SLE and the general population without SLE and the two groups were compared using age-adjusted incidence rate ratios (IRRs). Age-stratified IRRs were further analyzed. Results The annual IRs of pregnancy in SLE were 29.54–30.70 per 1000 persons. The IRRs were lower in women with SLE than in the general population: 0.68 (0.61–0.76), 0.66 (0.60–0.74), and 0.74 (0.66–0.82) in each respective year. The IRRs of fetal loss, IUGR, and pre-eclampsia/eclampsia were 1.30 (1.14–1.49), 4.65 (3.55–6.09), and 3.43 (2.70–4.36), respectively. However, the IRR of gestational diabetes in SLE did not significantly differ from that of women without SLE. Among the APOs, fetal loss, IUGR, and pre-eclampsia/eclampsia showed decreasing tendencies as age increased. Conclusions Pregnancy rates in SLE were approximately 30% lower than those in the general population. Except for gestational diabetes, fetal loss, IUGR, and pre-eclampsia/eclampsia were higher in SLE and showed a decreasing tendency with age.
Key Points • This population-based cohort study showed that pregnancy rates in SLE were approximately 30% lower than those in the general population. • SLE had a 1.3-fold higher rate of fetal loss, more than 4-fold higher IUGR rate, and more than 3-fold pre-eclampsia or eclampsia rate compared with the general population. • Adverse pregnancy outcomes in SLE showed a decreasing tendency with age.
Keywords Adverse pregnancy outcomes . Claims . Pregnancy rate . Systemic lupus erythematosus
Introduction Systemic lupus erythematosus (SLE) can affect people of all ages, but it occurs most often in women of childbearing age. It
* Yune-Jung Park [email protected] 1
Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon, Gyeonggi-do, Seoul 16247, Republic of Korea
has been documented that the fertility rate in women with SLE is similar to that in women without SLE [1, 2]. However, pregnancy in women with
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