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Predictors of post-partum damage accrual in systemic lupus erythematosus: data from LUMINA, a multiethnic US cohort (XXXVIII).
Rheumatology (Oxford) 2006; 45(11):1380-4R

Abstract

OBJECTIVE

To determine the impact of pregnancy on systemic lupus erythematosus (SLE) outcome.

METHODS

SLE patients, age >or=16 yrs, disease duration <or=5 yrs at enrolment in LUMINA, a multiethnic cohort (Hispanics, African-Americans and Caucasians), were studied. The first pregnancy after SLE diagnosis was examined. A good pregnancy outcome was a full-term delivery; an adverse outcome was a miscarriage, abortion, premature birth or stillbirth. Dependent variables were disease activity (Systemic Lupus Activity Measure-Revised, SLAM-R) and damage accrual [Systemic Lupus International Collaborating Clinics (SLICC) Damage Index, SDI]. Differences in these variables between the visit immediately prior to, and the first visit after, pregnancy and their relationship with pregnancy outcome were examined. Damage accrual due to pregnancy exposure was examined by a case-crossover design.

RESULTS

Sixty-three SLE women from all ethnic groups were included. The mean (S.D.) age and disease duration at pregnancy outcome were 27.6 (6.5) yrs and 18.3 (22.5) months, respectively. Adverse pregnancy outcomes occurred in 76.2% women. The SLAM-R and SDI scores were statistically different after pregnancy (P = 0.050 and P < 0.001, respectively); the SDI score was independent of pregnancy outcome but strongly associated with pregnancy duration (P = 0.006), disease activity (P = 0.001), damage prior to pregnancy (P < 0.001) and total disease duration (P = 0.039) by multivariable analyses. Exposure to pregnancy itself did not impact on damage accrual in the case-crossover analyses of 142 patients (17 pregnancy exposures) (OR = 1.25; 95% CI 0.336-4.655; P = 0.480).

CONCLUSIONS

Pregnancy duration, total disease duration, disease activity and damage immediately prior to pregnancy decisively impact on damage accrual after pregnancy in patients with SLE.

Authors+Show Affiliations

Department of Medicine, Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, AL, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16880189

Citation

Andrade, R M., et al. "Predictors of Post-partum Damage Accrual in Systemic Lupus Erythematosus: Data From LUMINA, a Multiethnic US Cohort (XXXVIII)." Rheumatology (Oxford, England), vol. 45, no. 11, 2006, pp. 1380-4.
Andrade RM, McGwin G, Alarcón GS, et al. Predictors of post-partum damage accrual in systemic lupus erythematosus: data from LUMINA, a multiethnic US cohort (XXXVIII). Rheumatology (Oxford). 2006;45(11):1380-4.
Andrade, R. M., McGwin, G., Alarcón, G. S., Sanchez, M. L., Bertoli, A. M., Fernández, M., ... Reveille, J. D. (2006). Predictors of post-partum damage accrual in systemic lupus erythematosus: data from LUMINA, a multiethnic US cohort (XXXVIII). Rheumatology (Oxford, England), 45(11), pp. 1380-4.
Andrade RM, et al. Predictors of Post-partum Damage Accrual in Systemic Lupus Erythematosus: Data From LUMINA, a Multiethnic US Cohort (XXXVIII). Rheumatology (Oxford). 2006;45(11):1380-4. PubMed PMID: 16880189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of post-partum damage accrual in systemic lupus erythematosus: data from LUMINA, a multiethnic US cohort (XXXVIII). AU - Andrade,R M, AU - McGwin,G,Jr AU - Alarcón,G S, AU - Sanchez,M L, AU - Bertoli,A M, AU - Fernández,M, AU - Fessler,B J, AU - Apte,M, AU - Arango,A M, AU - Bastian,H M, AU - Vilá,L M, AU - Reveille,J D, AU - ,, Y1 - 2006/07/31/ PY - 2006/8/2/pubmed PY - 2006/12/15/medline PY - 2006/8/2/entrez SP - 1380 EP - 4 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 45 IS - 11 N2 - OBJECTIVE: To determine the impact of pregnancy on systemic lupus erythematosus (SLE) outcome. METHODS: SLE patients, age >or=16 yrs, disease duration <or=5 yrs at enrolment in LUMINA, a multiethnic cohort (Hispanics, African-Americans and Caucasians), were studied. The first pregnancy after SLE diagnosis was examined. A good pregnancy outcome was a full-term delivery; an adverse outcome was a miscarriage, abortion, premature birth or stillbirth. Dependent variables were disease activity (Systemic Lupus Activity Measure-Revised, SLAM-R) and damage accrual [Systemic Lupus International Collaborating Clinics (SLICC) Damage Index, SDI]. Differences in these variables between the visit immediately prior to, and the first visit after, pregnancy and their relationship with pregnancy outcome were examined. Damage accrual due to pregnancy exposure was examined by a case-crossover design. RESULTS: Sixty-three SLE women from all ethnic groups were included. The mean (S.D.) age and disease duration at pregnancy outcome were 27.6 (6.5) yrs and 18.3 (22.5) months, respectively. Adverse pregnancy outcomes occurred in 76.2% women. The SLAM-R and SDI scores were statistically different after pregnancy (P = 0.050 and P < 0.001, respectively); the SDI score was independent of pregnancy outcome but strongly associated with pregnancy duration (P = 0.006), disease activity (P = 0.001), damage prior to pregnancy (P < 0.001) and total disease duration (P = 0.039) by multivariable analyses. Exposure to pregnancy itself did not impact on damage accrual in the case-crossover analyses of 142 patients (17 pregnancy exposures) (OR = 1.25; 95% CI 0.336-4.655; P = 0.480). CONCLUSIONS: Pregnancy duration, total disease duration, disease activity and damage immediately prior to pregnancy decisively impact on damage accrual after pregnancy in patients with SLE. SN - 1462-0324 UR - https://www.unboundmedicine.com/medline/citation/16880189/Predictors_of_post_partum_damage_accrual_in_systemic_lupus_erythematosus:_data_from_LUMINA_a_multiethnic_US_cohort__XXXVIII__ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kel222 DB - PRIME DP - Unbound Medicine ER -