Positive progress for SLE pregnancies

Recent findings identify that loss of pregnancy rates in women with systemic lupus erythematosus (SLE) has declined markedly over the last 40 years.To determine the pregnancy loss and pre-term delivery rates in SLE patients, Dr Carl Laskin and colleagues evaluated outcome data for the past three years in their own subjects and compared them with the literature over the past 40 years. The literature reports were grouped into five-year periods and analysed in comparison with population norms for the same periods.The authors report that the rate of loss in SLE pregnancies reduced from a mean of 43% in 1960-1965 to 17% in 2000-2003. "This approximates the pregnancy loss rate in the general US population," at 16.1% in 2000.Dr Laskin's group comments that it was not possible to evaluate pre-term deliveries prior to 1980 due to inconsistent reporting. However, an insignificant trend toward a decrease in pre-term delivery rates was noted from 1980 to 2000 (from 37% to 32%) in SLE patients, compared with a significant increase in the percentage of pre-term births in the general population during the same interval (from 9.4% to 12.1%)."Improvements in disease management and perinatal monitoring have resulted in a significant decrease in pregnancy loss in SLE over the last 40 years and a trend toward decreased preterm deliveries over the last 20 years in comparison to the general population," the authors comment. Highlighting the importance of collaboration between rheumatologists and perinatologists, Laskin's group considers that the description of SLE-associated pregnancy could be revised to reflect a more positive prognosis for mother and fetus.Reference...