TOPLINE:

Women with systemic lupus erythematosus (SLE) were less likely to have a second delivery than those without SLE, especially if they had experienced adverse pregnancy outcomes (APOs) in their first delivery.

METHODOLOGY:

• Researchers conducted a register-based cohort study in Sweden to assess the rates of second deliveries and the recurrence of APOs in women with SLE.
• They analysed data of 543 women with SLE matched with 17,218 women without the disease (mean ages, 30.5 and 30.0 years, respectively). These women had their first singleton live birth between 2003 and 2020.
• Outcome measures were second deliveries and recurrence of APOs (preeclampsia, preterm birth, and a composite of any APO), compared between women with and without SLE.
• Women were followed up for a median duration of 2.3 years.

TAKEAWAY:

• Women with SLE had a lower incidence rate of second delivery per 1000 person-years than those without SLE (156 vs 176), corresponding to an adjusted hazard ratio (aHR) of 0.89 (95% CI, 0.80-0.99), with the 95% CI narrowly excluding 1.0.
• Among women who experienced any APO in their first delivery, those with SLE had a lower likelihood of a second delivery than those without SLE (aHR, 0.78; 95% CI, 0.63-0.96).
• Women with SLE had a higher risk for recurrence of any APO in their second delivery than those without SLE (42.3% vs 26.9%; adjusted risk ratio [aRR], 1.54; 95% CI, 1.18-2.00).
• The risk for recurrence of preterm delivery or preeclampsia was higher in women with vs without SLE, although the aRR was statistically significant only for preterm delivery.

IN PRACTICE:

"[The study] findings highlight the importance of close monitoring, individualized counselling, and tailored risk assessment before and during pregnancy in women with SLE," the authors of the study wrote.

SOURCE:

The study was led by Aleksandra Antovic, MD, PhD, Karolinska University Hospital, Stockholm, Sweden. It was published online on May 07, 2026, in Rheumatology.

LIMITATIONS:

The researchers did not have data on preconception disease activity, flares, and the organs involved. They could not examine miscarriages and had an inadequate number of foetal deaths to study. CIs were wide because of the small number of recurring events.

DISCLOSURES:

The study received support through a grant from Region Stockholm. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.