Reports on birth outcomes in autoimmune diseases from the ACR meeting.(OBSTETRICS)

Several posters at the annual meeting of the American College of Rheumatology reported on the following pregnancy outcomes for women who had autoimmune diseases or were taking drugs for autoimmune diseases:

* Lupus. A study of 198 women with clinically stable or mildly active systemic lupus erythematosus (SLE) at the time of conception found that they rarely developed severe SLE flares and generally had good pregnancy outcomes, Dr. Jane E. Salmon of the Hospital for Special Surgery, New York, and her associates reported.

Mild or moderate disease flares occurred in 6% of women within 20 weeks of gestation, in 5% at 32 weeks, and in 8% during the postpartum period, according to data from the PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study.

No severe flares occurred by 20 weeks. Severe flares were seen in fewer than 1% of women by 32 weeks and in 1.5% during the postpartum period in the ongoing prospective, multicenter, observational study.

Of the four severe SLE flares, two involved the central nervous system, one involved kidney disease, and the other was an arthritis flare.

Pregnancy complications occurred in 15% of women, and included fetal death (in 8%), neonatal death (3%), preeclampsia (15%), and fetal growth restriction (10%), with some women having more than one complication.

Although 28% of women had a past history of renal disease and 39% had blood abnormalities associated with active lupus, these were not associated with flares or poor pregnancy outcomes, Dr. Salmon reported. The investigators reported no relevant conflicts of interest.