Lupus, rheumatoid arthritis tied to higher risk for adverse obstetric, birth outcomes

Women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and their infants experience higher rates of adverse obstetric and birth outcomes, according to a study published online Jan. 10 in Arthritis Care & Research.

Namrata Singh, M.D., from the University of Washington in Seattle, and colleagues compared obstetric and birth outcomes and rehospitalization (within two years) among 1,223 women with RA, 1,354 women with SLE, and unexposed women, along with their infants.

The researchers found women with RA/SLE more often required rehospitalization, most notably within six months postpartum (RA: 4 versus 2 percent; relative risk, 2.22; SLE: 6 versus 2 percent; relative risk, 2.78). Musculoskeletal conditions (RA: hazard ratio, 19.1; SLE: hazard ratio, 29.8) were responsible for the most maternal postpartum rehospitalizations. Infants of women with SLE experienced more frequent rehospitalizations in their first year of life and also had more malformations (9 versus 6 percent; relative risk, 1.46) and increased mortality of less than two years (relative risk, 2.11).

"Women with RA or SLE and their infants experienced adverse outcomes, particularly infants of women with SLE. Maternal/infant rehospitalization was more common; most marked in the early months postpartum," the authors write. "Close follow-up during these time periods is crucial to minimize adverse outcomes."