Systemic lupus erythematosus is associated with an increased frequency of spontaneous preterm births: systematic review and meta-analysis - 22/04/24
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Abstract |
Objective |
Preterm birth is one of the most frequent complications of pregnancy in women with systemic lupus erythematosus. The high indicated preterm birth proportion due to hypertensive disorders of pregnancy and/or fetal growth restriction is well known, and preventive measures and screening for early detection are performed. The risk of spontaneous preterm birth is less well recognized. This study aimed to determine the proportions of spontaneous and indicated preterm birth in pregnancies of women with systemic lupus erythematosus.
Data Sources |
A systematic literature search using Pubmed, Embase, Web of Science, and Google Scholar was performed in June 2021.
Study Eligibility Criteria |
Studies in pregnant women with systemic lupus erythematosus reporting spontaneous and indicated preterm birth rates were selected. Original research articles published from 1995 to June 2021 were included.
Methods |
Quality and risk of bias of the included studies were assessed using the Newcastle–Ottawa quality assessment scale. To estimate the pooled event rates and 95% confidence intervals, meta-analysis of single proportions with a random-effects model was performed.
Results |
We included 21 articles, containing data of 8157 pregnancies in women with systemic lupus erythematosus. On average, 31% (95% prediction interval, 0.14–0.50) of the pregnancies resulted in preterm birth, including 14% (95% prediction interval, 0.04–0.27) spontaneous and 16% (95% prediction interval, 0.03–0.35) indicated preterm birth.
Conclusion |
In pregnant women with systemic lupus erythematosus, spontaneous and indicated preterm birth proportions are high. This information should be applied in (prepregnancy) counseling and management in pregnancy. The knowledge obtained by this meta-analysis paves the way for further research of associated risk factors and development of interventions to reduce spontaneous preterm birth in systemic lupus erythematosus pregnancies.
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Key words : iatrogenic preterm birth, indicated preterm birth, lupus, pregnancy, premature, preterm birth, preterm delivery, preterm labor, preterm prelabor rupture of membranes, rupture of membranes, spontaneous preterm birth, systemic lupus erythematosus
Plan
Drs Blomjous and Abheiden as co-first authors. |
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The authors report no conflict of interest. |
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The authors report no funding for this study. |
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Prospero registration |
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Registration date: April 22, 2021. |
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Registration number: CRD42021250697 |
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This study was presented at the 4th European Spontaneous Preterm Birth Congress of the Stichting Stop te vroeg bevallen, Haarlem, the Netherlands, September 20–22, 2023; the abstract was presented at the 14th European Lupus Meeting, SLEuro European Lupus Society, Brugge, Belgium, March 19–22, 2024. |
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