• Tue. Sep 27th, 2022

Study highlights importance of a multidisciplinary medical team for pregnant women with lupus

ByMadeleine J. Pierce

Jun 2, 2022

Copenhagen, Denmark, June 2, 2022 /PRNewswire/ — A study including researchers from the Hospital for Special Surgery (HSS) highlights the importance of a multidisciplinary medical team to counsel and provide care for women with systemic lupus erythematosus, the most common form of lupus, who become pregnant. Using a nationwide database, investigators reviewed the records of more than 50,000 lupus patients who gave birth over a 10-year period. The results revealed a higher rate of fetal morbidity and severe maternal morbidity compared to women who did not have lupus.

Bella MehtaMBBS, MS, a rheumatologist at HSS and lead author of the study, presented the results today at the European Alliance of Rheumatology Associations (EULAR) Congress 2022 at Copenhagen. “Lupus is a chronic autoimmune disease that often affects women of childbearing age,” Dr. Mehta explained. “In our previous work, we demonstrated that over the years, maternal and fetal mortality in patients with lupus improved significantly, which was very reassuring for the patients. However, morbidity was less known. We set out to assess and quantify indicators of fetal and maternal morbidity in women with lupus compared to those without the disease.”

Using retrospective data from the National Inpatient Database, researchers identified childbirth-related hospital admissions from 2008 to 2017. Indicators of fetal morbidity included preterm birth and intrauterine growth restriction. Twenty-one indicators of severe maternal morbidity have been identified and defined as unexpected outcomes of labor and delivery that have significant short- or long-term consequences for a woman’s health.

Of the 40 million hospital admissions related to childbirth, 51,161 patients are believed to have lupus. These patients were more likely to be older than women without lupus (30.1 years versus 28.2 years), to be African American (25% versus 15%), and to receive Medicare ( 5% versus 1%).

During childbirth, women with lupus were 15 times more likely to develop acute kidney injury than those without (1.5% vs. 0.1%), four times more likely to develop a cerebrovascular disorder (4.8% versus 1.1%), and nearly four times more likely to require a blood transfusion (4.0% versus 1.1%). Women with lupus were also more likely to develop cardiovascular and peripheral vascular disorders (1.1% vs. 0.1%).

In terms of fetal morbidity, mothers with lupus were twice as likely to deliver preterm (14.5% versus 7.3%) and almost three times more likely to experience growth retardation in the uterus compared to pregnant patients without lupus (8.0% versus 2.7%).

“The number of coexisting health conditions in pregnant women with lupus was much higher than in women who did not have lupus. It seems likely that these comorbidities are responsible – at least in part – for the increased risk of morbidity fetal and maternal in patients with lupus,” Dr. Mehta said. complexity of managing these patients.”

Dr. Mehta continued, “Our study is not intended to discourage women with lupus from becoming pregnant. We believe our results can help patients and their physicians assess risk, establish appropriate interventions, and ensure that a multidisciplinary medical team is in place to counsel patients and manage their care.

Authors: Bella MehtaMBBS, MS, Katharine Kayla J. Glaser, Deanna Jannat-Khah (HSS), Yiming Luo (National Institutes of Health, Medicine, Bethesda), Lisa R. Sammaritanodoctor, Jane E. Salmondoctor, Susan M. GoodmanMD (HSS), Fei Wang (Weill Cornell Medicine).

About RSS

HSS is the world’s first academic medical center focused on musculoskeletal health. At its heart is the Hospital for Special Surgery, ranked #1 in Orthopedics nationally (for the 12th consecutive year), #4 in Rheumatology by US News & World Report (2021-2022), and Best Orthopedic Hospital Pediatrics of NY, NJ and CT by US News & World Report “Best Hospitals for Children” (2021-2022). In a survey of healthcare professionals in over 20 countries by Newsweek, HSS is ranked #1 worldwide in orthopedics for a second consecutive year (2022). Founded in 1863, the hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State receive five consecutive Magnet Recognition for Excellence in Nursing from the American Nurses Credentialing Center. A subsidiary of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York StateAs good as inside Florida. In addition to patient care, HSS is at the forefront of research, innovation and education. The HSS Research Institute includes 20 laboratories and 300 staff members who focus on advancing musculoskeletal health through the prevention of tissue degeneration, repair and regeneration. The HSS Innovation Institute strives to realize the potential of new drugs, therapies and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, college students and consumers in more than 145 countries. The institution collaborates with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class SSS care more widely available nationally and internationally. www.hss.edu.

SOURCE Special Surgery Hospital