RESEARCH - Obstetric hospitizations in the US for women with SLE and RA

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Arthritis Rheum. 2006 Mar;54(3):899-907.

Obstetric hospitalizations in the United States for women with systemic

lupus erythematosus and rheumatoid arthritis.

Chakravarty EF, L, Krishnan E.

Division of Immunology and Rheumatology, Stanford University School of

Medicine, Stanford, California, USA. echakravarty@...

OBJECTIVE: To estimate the national occurrence of pregnancies in women with

systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and to

compare pregnancy outcomes in these patients with those in women with

pregestational diabetes mellitus (DM) and with the general obstetric

population. METHODS: We studied the 2002 Nationwide Inpatient Sample of the

Healthcare Cost and Utilization Project to estimate the number of obstetric

hospitalizations, deliveries, and cesarean deliveries in women with SLE, RA,

pregestational DM, and the general obstetric population. Pregnancy outcomes

included length of hospital stay, hypertensive disorders including

preeclampsia, premature rupture of membranes, and intrauterine growth

restriction. RESULTS: Of an estimated 4.04 million deliveries, 3,264

occurred in women with SLE, 1,425 in women with RA, and 13,574 in women with

pregestational DM. Women with SLE, RA, and pregestational DM had

significantly increased rates of hypertensive disorders compared with the

general obstetric population (23.2%, 11.1%, 27.4%, and 7.8%, respectively),

longer hospital stays, and significantly higher risk of cesarean delivery.

Although women with SLE, RA, and pregestational DM were significantly older

than women in the general obstetric population, disparities in the risk of

adverse outcomes of pregnancy remained statistically significant after

adjustment for maternal age.

CONCLUSION: To our knowledge, this is the first study to examine national

data on pregnancy outcomes in women with common rheumatic diseases. As with

underlying pregestational DM, women with SLE and RA appear to have a higher

age-adjusted risk of adverse outcomes of pregnancy and longer hospital stays

than do pregnant women in the general population, and careful antenatal

monitoring should be performed.

PMID: 16508972

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16508972

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