Pre-conception status, obstetric outcome and use of medications during pregnancy of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) in Japan: Multi-center retrospective descriptive study

Abstract

Objective: To describe the pre-conception status, pregnancy outcomes, and medication prevalence in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Crohn’s disease (CD), and ulcerative colitis (UC).

Methods: E-mail-based questionnaire survey for the Japan Maternal Fetal Intensive Care Unit Network hospitals inquiring prevalence and clinical features of SLE, RA, CD and UC complicated pregnancies for 2 years.

Results: The number of SLE, RA, CD and UC among 69,810 deliveries was 184, 139, 27 and 178, respectively. Less than half of pregnancies were planned. Assisted reproductive technology (ART) pregnancy rates were higher in SLE, RA and UC than in the general population (11.4, 23.0 and 7.4 vs 5.1%, p < .001 each). Preterm delivery, preeclampsia, and fetal growth restriction (FGR) were more frequent in SLE than in the general population (39.4 vs. 5.6% p < .001, 15.0 vs. 6.0% p < .001, 12.9 vs 4.2% p < .001). Prevalence of preterm delivery in RA and UC (27.5 vs. 5.6% p < .001, 11.3 vs. 5.6% p < .05) and FGR in CD (28.6 vs. 4.2% p < .001) was also higher than that in the general population.

Conclusion: SLE, RA, CD, and UC complicated pregnancies were at high risks of obstetric adverse outcome. High ART rates necessitate pre-conception counseling in SLE, RA, and UC pregnancies.

Keywords:

• Crohn’s disease
• pregnancy
• rheumatoid arthritis
• systemic lupus erythematosus
• ulcerative colitis

Acknowledgement

The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Author contributions

Conception and design: SS, ST, AS and MS. Data acquisition, analysis: ST, AS and MS. Interpretation of data: SS, ST, AS and MS. Drafting manuscript: ST and SS. Revision of the manuscript for important intellectual content: ST, AS, MS, HK, DF, SM, AM, YM, KM, TS, MW, YS, AM, TA, KO, NM, ST, TM, TN, KN and SS.

Conflict of interest

YM has received grants from Asahi Kasei Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Teijin. KM has received consulting fees, speaking fees, and/or honoraria from Bristol-Myers Squibb, Astellas, Chugai, and has received research grants from Astellas and Chugai. YS has received speaking fees from abbvie, Mitsubishi Tanabe Pharma, Zeria Pharmaceutical Co., Ltd., MOCHIDA PHARMACEUTICAL CO., LTD., KYORIN Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., and has received research grants from Abbvie, Mitsubishi Tanabe Pharma, EA Pharma Co., Ltd., JIMRO Co., Ltd, MOCHIDA PHARMACEUTICAL CO., LTD., and Kissei Pharmaceutical Co., Ltd. MN were paid personal fees by Janssen Pharma, Pfizer Inc., Mitsubishi Tanabe Pharma., Kyorin Pharma., Mochida Pharma., Takeda Pharma., Nichi-Iko Pharma., Kissei Pharma., Zeria Pharma., Nippon Kayaku, Astellas Pharma., and AbbVie Inc. AM received research grants/honoraria from Astellas Pharma Co. Ltd., Ltd., Chugai Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Co. Ltd. SS has received speaking fees from Astellas Pharma Inc. and UCB Japan Co. Ltd.

Additional information

Funding

This work was supported by the Health Labour Sciences Research Grant H28-Nanchitou(Nan)-Ippan-023.