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Pregnancy rates and perinatal outcomes in women with systemic lupus erythematosus: data from the Korean national health claims database

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Abstract

Introduction/Objectives

The pregnancy rate in systemic lupus erythematosus (SLE) is not fully understood and comparisons of adverse pregnancy outcomes (APOs) with SLE versus the general population are limited. This study aimed to estimate the pregnancy rate and APOs in Korean SLE compared to those without SLE.

Method

Pregnant women were identified using the ICD-10 codes for delivery and abortion in the Korean national health claims database (2013–2015). APOs were classified as fetal loss, intrauterine growth retardation (IUGR), pre-eclampsia/eclampsia, and gestational diabetes. Annual incidence rates (IRs) of pregnancy and APOs were calculated in women with SLE and the general population without SLE and the two groups were compared using age-adjusted incidence rate ratios (IRRs). Age-stratified IRRs were further analyzed.

Results

The annual IRs of pregnancy in SLE were 29.54–30.70 per 1000 persons. The IRRs were lower in women with SLE than in the general population: 0.68 (0.61–0.76), 0.66 (0.60–0.74), and 0.74 (0.66–0.82) in each respective year. The IRRs of fetal loss, IUGR, and pre-eclampsia/eclampsia were 1.30 (1.14–1.49), 4.65 (3.55–6.09), and 3.43 (2.70–4.36), respectively. However, the IRR of gestational diabetes in SLE did not significantly differ from that of women without SLE. Among the APOs, fetal loss, IUGR, and pre-eclampsia/eclampsia showed decreasing tendencies as age increased.

Conclusions

Pregnancy rates in SLE were approximately 30% lower than those in the general population. Except for gestational diabetes, fetal loss, IUGR, and pre-eclampsia/eclampsia were higher in SLE and showed a decreasing tendency with age.

Key Points

• This population-based cohort study showed that pregnancy rates in SLE were approximately 30% lower than those in the general population.

• SLE had a 1.3-fold higher rate of fetal loss, more than 4-fold higher IUGR rate, and more than 3-fold pre-eclampsia or eclampsia rate compared with the general population.

• Adverse pregnancy outcomes in SLE showed a decreasing tendency with age.

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Acknowledgments

This study was conducted with the Department of Big Data in the Health Insurance Review and Assessment Service.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon, Gyeonggi-do, Seoul, 16247, Republic of Korea

    Young Bin Joo, Ki-Jo Kim, Kyung-Su Park & Yune-Jung Park

Authors
  1. Young Bin Joo
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  2. Ki-Jo Kim
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  4. Yune-Jung Park
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Contributions

Study conception and design: Young Bin Joo and Yune-Jung Park

Acquisition of data: Young Bin Joo

Analysis and interpretation of data: Young Bin Joo, Ki-Jo Kim, Kyung-Su Park, Yune-Jung Park

All authors were involved in drafting the article critically for important intellectual content, and all authors approved the final version to be published. Dr. Park had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Yune-Jung Park.

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This study was approved by the Institutional Ethics Review Board of St. Vincent’s Hospital, Catholic University of Korea

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Joo, Y.B., Kim, KJ., Park, KS. et al. Pregnancy rates and perinatal outcomes in women with systemic lupus erythematosus: data from the Korean national health claims database. Clin Rheumatol 40, 2243–2250 (2021). https://doi.org/10.1007/s10067-020-05496-4

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  • DOI: https://doi.org/10.1007/s10067-020-05496-4

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