Risk of Adverse Perinatal Outcomes Among Black Women With SLE

African American women with systemic lupus erythematosus (SLE) are at increased risk of preterm or small-for-gestational age births, even before receiving a clinical diagnosis of SLE, reported researchers at Emory University in Atlanta, Georgia.

The investigators, noting the paucity of research into the perinatal outcomes of Black women with SLE, conducted the study to determine the risk of adverse perinatal outcomes among these patients. They also factored in the time between the diagnosis of SLE and the time of the birth.

Using the Georgia Lupus Registry and the Georgians Organized Against Lupus Cohort, researchers identified women with SLE and then categorized them into 4 groups: women who had births more than 3 years before SLE diagnosis; births 0-3 years before SLE diagnosis; births 0-3 years after SLE diagnosis; and births more than 3 years after SLE diagnosis. A comparison group was also created using birth certificates of infants born to Black women in the same geographic area, obtained from the National Center for Health Statistics.

The researchers compared the risk of preterm birth or small-for-gestational age birth among SLE births in each group to the general population. Data was adjusted for maternal age, education, and parity.

Researchers wrote that “births to women with SLE were more likely to occur preterm 0-3 years before SLE diagnosis (risk ratio [RR]: 1.71, 95% confidence interval [CI]: 1.24, 2.35), 0-3 years after SLE diagnosis (RR: 2.29, 95% CI: 1.70, 3.09) and 3 or more years after diagnosis (RR: 2.83, 95% CI: 2.36, 3.38), but not 3 or more years before SLE diagnosis compared to the general population (RR: 1.03, 95% CI: 0.77, 1.38).” The results for the risk of small-for-gestational age births were similar.

—Allison Casey

Reference:

Angley M, Drews-Botsch C, Lewis TT, Badell M, Lim SS, Howards PP. Adverse perinatal outcomes before and after diagnosis with systemic lupus erythematosus among African American women. Arthritis Care Res. Published online: 20 December 2021. DOI: https://doi.org/10.1002/acr.24848