- A large US cohort study finds that in-hospital maternal deaths over the course of the last 18 years in patients with systemic lupus erythematosus (SLE) has declined from 34 times higher than non-SLE pregnancies to less than 5 times higher.
Why this matters
- The authors still regard SLE as a high-risk pregnancy.
- An editorial regards the progress as "substantial," but still perceives the need for further progress and is concerned about preeclampsia and fetal deaths.
- Retrospective cohort using the National Inpatient Sample, which covers 99% of the US hospitalized population from 1998 to 2000 and 2013 to 2015.
- Outcomes were analyzed for pregnant women with SLE (n=93,820) compared with those without SLE (n=78,045,054).
- Funding: None.
- Maternal deaths among SLE (vs non-SLE) pregnancies declined from 442 vs 13 to
- Fetal deaths among SLE (vs non-SLE) pregnancies nonsignificantly declined from 268 vs 72 to 153 vs 66 per 10,000 deliveries; difference in trends, P=.064.
- Preeclampsia or eclampsia among SLE (vs non-SLE) pregnancies declined from 9.5% vs 3.3% to 9.1% vs 4.1% of deliveries; difference in trends, P<.001.>
- Retrospective, observational design.
- No data on hospital-specific trends, SLE disease activity, and medications.