Pregnancy outcomes in systemic lupus erythematosus: experience from a Caribbean center

Abstract

Background

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune multi-system disorder frequently affecting black women of childbearing age. No published data exist on the obstetric outcomes in a Caribbean population.

Objective

We analyzed pregnancy outcomes in an Afro-Caribbean cohort of women with SLE at a tertiary university hospital.

Methods

A retrospective cohort study was performed of all pregnant women with SLE prior to pregnancy from January 1990 to December 2021 at the University Hospital of the West Indies (UHWI), Jamaica. Maternal rheumatologic, obstetric, fetal/neonatal data were analyzed. Descriptive statistical analyses were performed. To determine if outcomes were associated with various factors, Spearman’s rho was followed by logistic regression analysis to estimate unadjusted odds ratios with statistical significance at p < 0.05.

Results

A total of 56 pregnancies in 47 women were identified with SLE. Live births were 87.5%, with 10.7% spontaneous miscarriages and no neonatal deaths. Prednisone was the most used drug in 67.9% of patients. 85% of women had an adverse outcome with an adverse fetal outcome occurring in 55% of cases. Prednisone was associated with an adverse fetal/neonatal outcome (Spearman’s rho = 0.38; p = .004).

Conclusion

In this first Caribbean series on SLE in pregnancy, reasonably successful pregnancy outcomes are achievable in Afro-Caribbean women managed in multidisciplinary centers.

Keywords:

• Systemic lupus
• pregnancy outcomes
• Caribbean
• auto-immune

Acknowledgements

We would like to thank Professor J Kennedy Cruickshank for his assistance and guidance in this research.

Author contributions

TH, KM and SSB researched the literature and conceived the study. TH and SSB were involved in protocol development and gaining ethical approval. SG, SSB and SH were involved in patient recruitment. SH and MGW were involved in data analysis. SG, SSB, TH and NJ wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, TH, upon request.

Additional information

Funding

This research received no specific grant from any funding agency in the public commercial or non-for-profit sectors.