The effect of parity, history of preeclampsia, and pregnancy care on the incidence of subsequent preeclampsia in multiparous women with SLE

Abstract

Objectives

To clarify the correlation between preeclampsia and parity and to identify protective factors against preeclampsia in multiparous women with systemic lupus erythematosus (SLE).

Methods

We conducted a single-center, retrospective chart review study of 85 pregnant women. We used multiple logistic regression analysis to assess the association between parity and preeclampsia in women with SLE, and described the detailed clinical courses and management of four women with a history of severe preeclampsia and of a woman who experienced preeclampsia during her latest pregnancy.

Results

Multiparity was significantly associated with a low risk of preeclampsia (adjusted odds ratio: 0.08; 95% confidence interval: 0.01–0.95). One multiparous woman without a history of preeclampsia developed preeclampsia during her latest pregnancy; she had critical risk factors for preeclampsia, including chronic kidney disease and hypertension, and was not administered aspirin. In contrast, four multiparous women with a history of severe preeclampsia received adequate medications; they did not develop recurrent preeclampsia and delivered live newborns.

Conclusions

Multiparity and maintenance therapy for SLE before and during pregnancy and preventive treatment for preeclampsia may improve outcomes in subsequent pregnancies.

Keywords:

• Aspirin
• parity
• pre-eclampsia
• pregnancy
• systemic lupus erythematosus

Conflict of interest

A. Murashima has received a research grant from Chugai Pharmaceutical Co. Ltd., and has received lecture fees from Astellas Pharma Inc., Chugai Pharmaceutical Co. Ltd., and Bristol-Myers K.K. Others have nothing to declare.