Effect of pregnancy on disease flares in patients with systemic lupus erythematosus

Annals of the Rheumatic Diseases
Amanda M EudyMichelle Petri

Abstract

Prior studies found conflicting results about whether lupus is likely to flare during or after pregnancy. Using a large cohort of pregnant and non-pregnant women with lupus, we estimated the effect of pregnancy on disease flares in systemic lupus erythematosus. Data were collected in the Hopkins Lupus Cohort 1987-2015. Women aged 14-45 years with >1 measurement of disease activity were included. The time-varying exposures were classified as pregnancy, postpartum or non-pregnant/non-postpartum periods. Flares were defined as: (1) change in Physician Global Assessment (PGA)≥1 from previous visit and (2) change in Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI)≥4 from previous visit. A stratified Cox model estimated HRs with bootstrap 95% CIs. There were 1349 patients, including 398 pregnancies in 304 patients. There was an increased rate of flare defined by PGA during pregnancy (HR: 1.59; 95% CI 1.27 to 1.96); however, this effect was modified by hydroxychloroquine (HCQ) use, with the HR of flares in pregnancy compared with non-pregnant/non-postpartum periods estimated to be 1.83 (95% CI 1.34 to 2.45) for patients with no HCQ use and 1.26 (95% CI 0.88 to 1.69) f...Continue Reading

References

Dec 1, 1985·Clinics in Rheumatic Diseases·M D Lockshin
Nov 1, 1982·Arthritis and Rheumatism·E M TanR J Winchester
Oct 1, 1993·Arthritis and Rheumatism·M B UrowitzJ McDonald
Feb 1, 1996·British Journal of Rheumatology·G Ruiz-IrastorzaN M Buchanan
Sep 15, 2000·Rheumatology·P E GeorgiouA A Drosos
Jul 26, 1962·The New England Journal of Medicine·M GARSENSTEINR M KARK
Oct 28, 2003·Clinical Rheumatology·M BoyanovP Popivanov
Feb 5, 2005·Arthritis and Rheumatism·Megan E B ClowseMichelle Petri
Jun 23, 2005·American Journal of Obstetrics and Gynecology·Eliza F ChakravartyMaurice L Druzin
Nov 1, 2006·Arthritis and Rheumatism·Megan E B ClowseMichelle Petri
May 23, 2007·Clinical Rheumatology·Javier A CavallascaGustavo G Nasswetter
Jul 16, 2009·Clinical Reviews in Allergy & Immunology·Graziela CarvalheirasCarlos Vasconcelos
Mar 17, 2010·The Journal of Rheumatology·Dafna D GladmanMurray B Urowitz

❮ Previous
Next ❯

Citations

Sep 20, 2018·Expert Review of Clinical Pharmacology·Maria GerosaCecilia Beatrice Chighizola
Mar 16, 2018·Nature Reviews. Rheumatology·Sarah Onuora
Mar 16, 2019·Arthritis Care & Research·Mehret Birru TalabiSonya Borrero
Apr 13, 2018·Annals of the Rheumatic Diseases·Amanda M EudyMichelle Petri
Apr 13, 2018·Annals of the Rheumatic Diseases·Christine Betzold
Sep 21, 2019·PloS One·Syahrul Sazliyana ShaharirRahana Abdul Rahman
Oct 16, 2019·The Australasian Journal of Dermatology·Christopher Y ChewAmanda M Saracino
Jan 3, 2019·The Journal of Rheumatology·Bonnie L Bermas
Dec 1, 2020·Revista brasileira de ginecologia e obstetrícia : revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia·Rahana Abd RahmanAni Amelia Zainuddin
Jan 15, 2021·Journal of Clinical Medicine·Matteo Piga, Laurent Arnaud
May 22, 2021·Journal of Autoimmunity·Jonathon J GrahamMichael A Heneghan
Sep 21, 2020·Dermatology : International Journal for Clinical and Investigative Dermatology·Maria Rita NascaGiuseppe Micali

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antimalarial Agents (ASM)

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.

Antimalarial Agents

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.