Clinical Edge

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Adverse Pregnancy Outcomes in Women with SLE

Arthritis Care Res; ePub 2017 Dec 29; Kaplowitz, et al

For African American women with systemic lupus erythematosus (SLE) without antiphospholipid antibodies (aPL), a recent study found that socioeconomic status (SES) is a key contributor to disparities in adverse pregnancy outcomes (APO), despite monthly care from experts, whereas other factors contribute to disparities in SLE with aPL. Data were from the PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study, a multicenter study that enrolled 346 patients with SLE and 62 patients with SLE and aPL (50% white, 20% African American, 17% Hispanic, 12% Asian/Pacific Islander). Measures of SES were educational attainment, median community income, and community education. Researchers found:

  • The frequency of APO in white women with SLE, with and without aPL, was 29% and 11%, respectively.
  • For African American and Hispanic women, it was approximately 2-fold greater.
  • In African American women with SLE alone, adjustment for clinical variables attenuated the odds ratio (OR) from 2.7 to 2.3, and after additional adjustment for SES, there were no longer significant differences in APO compared to whites.

Kaplowitz ET, Ferguson S, Guerra M, et al. Contribution of socioeconomic status to racial/ethnic disparities in adverse pregnancy outcomes among women with systemic lupus erythematosus. [Published online ahead of print December 29, 2017]. Arthritis Care Res. doi:10.1002/acr.23263.

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