Canadian Pregnancy Outcomes in Rheumatoid Arthritis and Systemic Lupus Erythematosus

Abstract

Objective. To describe obstetrical and neonataloutcomes in Canadian women with rheumatoid arthritis (RA) orsystemic lupus erythematosus (SLE). Methods. Anadministrative database of hospitalizations for neonatal delivery(1998–2009) from Calgary, Alberta was searched to identifywomen with RA (38 pregnancies) or SLE (95 pregnancies), and womenfrom the general population matched on maternal age and year ofdelivery (150 and 375 pregnancies, resp.). Conditionallogistic regression was used to calculate odds ratios (OR) formaternal and neonatal outcomes, adjusting for parity. Results. Women with SLE had increased odds forpreeclampsia or eclampsia (SLE OR 2.16 (95% CI 1.10–4.21;); RA OR 2.33 (95% CI 0.76–7.14; )). Women with SLEhad increased odds for cesarean section after adjustment fordysfunctional labour, instrumentation and previous cesareansection (OR 3.47 (95% CI 1.67–7.22; )). Neonates born towomen with SLE had increased odds of prematurity (SLE OR 6.17(95% CI 3.28–11.58; ); RA OR 2.66 (95% CI 0.90–7.84;)) and of SGA (SLE OR 2.54 (95% CI 1.42–4.55; ); RAOR 2.18 (95% CI 0.84–5.66; )) after adjusting for maternalhypertension. There was no excess risk of congenital defects inneonates. Conclusions. There is increased obstetrical and neonatal morbidityin Canadian women with RA or SLE.