SAN DIEGO — In pregnant women with systemic lupus erythematosus (SLE), those with ill-timed pregnancies had poorer pregnancy outcomes, including preeclampsia and preterm birth.
Dr Catherine Sims
Women with autoimmune conditions are at an increased risk for pregnancy complications, including pregnancy loss, preterm delivery, and increased need for cesarean delivery, said Catherine Sims, MD, a rheumatologist at Duke Health in Durham, North Carolina, who is focused on reproductive rheumatology. "The natural question, both clinically and from a research perspective, is, 'what can we do in order to mitigate or minimize these complications?' " she said during a presentation at the American College of Rheumatology 2023 Annual Meeting.
While research suggests that patients who plan their pregnancies during times of well-controlled disease have the "best chances of improved pregnancy outcomes," Sims and her colleagues wanted to quantify how planning for pregnancy affected reproductive outcomes.
Sims recruited pregnant women with SLE and assessed if the women were medically optimized for pregnancy, if the pregnancy was intended, or both. Intended pregnancy was assessed by using a validated self-reported survey called the London Measure of Unplanned Pregnancy. Pregnant women were considered "medically optimized" for pregnancy if they were not on teratogenic medication, had continued pregnancy-compatible SLE medications, and had a urine protein-creatinine ratio of less than 1 gram in the 6 months prior to or during the first trimester.
