Trends in and outcomes of delivery hospitalizations with lupus and antiphospholipid syndrome

被引:0
作者
Lopez, Ashley [1 ]
Wen, Timothy [2 ]
Patel, Naomi [3 ]
Booker, Whitney A. [1 ]
D'Alton, Mary E. [1 ]
Friedman, Alexander M. [1 ,4 ]
机构
[1] Columbia Univ, Dept Obstet & Gynecol, New York, NY USA
[2] Univ Calif San Francisco, Dept Obstet & Gynecol, San Francisco, CA USA
[3] Massachusetts Gen Hosp, Dept Med, Div Rheumatol Allergy & Immunol, Boston, MA USA
[4] Columbia Univ, Coll Phys & Surg, Dept Obstet & Gynecol, Div Maternal Fetal Fetal Med, 622 West 168th St, New York, NY 10032 USA
关键词
antiphospholipid antibody syndrome; lupus; maternal outcomes; maternal safety; severe maternal morbidity; ERYTHEMATOSUS;
D O I
10.1002/ijgo.15171
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
ObjectiveTo assess trends and outcomes associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) during US delivery hospitalizations.Study DesignThe National Inpatient Sample from 2000 to 2019 was used for this repeated cross-sectional analysis. We identified delivery hospitalizations with and without SLE. Temporal trends in SLE during delivery hospitalizations were determined using joinpoint regression. Adjusted logistic regression models accounting for demographic, clinical, and hospital factors were used to determine adjusted odds ratios (aORs) for adverse outcomes based on the presence or absence of SLE.ResultsOf an estimated 76 698 775 delivery hospitalizations identified in the NIS, 79386 (0.10%) had an associated diagnosis of SLE. Over the study period, SLE increased from 6.7 to 14.6 cases per 10 000 delivery hospitalizations (average annual percent change 4.5%, 95% CI 4.0-5.1). Deliveries with SLE had greater odds of non-transfusion severe morbidity (aOR 2.21, 95% CI 2.00, 2.44) and underwent a larger absolute increase in morbidity risk over the study period. SLE was associated with a range of other adverse outcomes including preterm delivery, eclampsia, cesarean delivery, and blood transfusion.ConclusionThe proportion of deliveries to women with SLE has increased over time in the US, and SLE and APS are associated with a broad range of adverse outcomes. In recent years, lupus diagnoses continued to increase during delivery hospitalization. Severe morbidity is increasing in this population.
引用
收藏
页码:1001 / 1009
页数:9
相关论文
共 26 条
[1]   Low-Dose Aspirin Use During Pregnancy [J].
Porter, T. Flint ;
Gyamfi-Bannerman, Cynthia ;
Manuck, Tracy .
OBSTETRICS AND GYNECOLOGY, 2018, 132 (01) :E44-E52
[2]   Development of a Comorbidity Index for Use in Obstetric Patients [J].
不详 .
OBSTETRICS AND GYNECOLOGY, 2013, 122 (05) :957-965
[3]  
Centers for Disease Control and Prevention, Severe maternal morbidity in the United States
[4]   Identification of Delivery Encounters Using International Classification of Diseases, Tenth Revision, Diagnosis and Procedure Codes [J].
Clapp, Mark A. ;
James, Kaitlyn E. ;
Friedman, Alexander M. .
OBSTETRICS AND GYNECOLOGY, 2020, 136 (04) :765-767
[5]   Lupus activity in pregnancy [J].
Clowse, Megan E. B. .
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA, 2007, 33 (02) :237-+
[6]   A national study of the complications of lupus in pregnancy [J].
Clowse, Megan E. B. ;
Jamison, Margaret ;
Myers, Evan ;
James, Andra H. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2008, 199 (02) :127.e1-127.e6
[7]   Clinical predictors of fetal and maternal outcome in systemic lupus erythematosus:: a prospective study of 103 pregnancies [J].
Cortés-Hernández, J ;
Ordi-Ros, J ;
Paredes, F ;
Casellas, M ;
Castillo, F ;
Vilardell-Tarres, M .
RHEUMATOLOGY, 2002, 41 (06) :643-650
[8]   Rising incidence and prevalence of systemic lupus erythematosus: a population-based study over four decades [J].
Duarte-Garcia, Ali ;
Hocaoglu, Mehmet ;
Valenzuela-Almada, Maria ;
Osei-Onomah, Shirley-Ann ;
Dabit, Jesse Y. ;
Sanchez-Rodriguez, Alain ;
Duong, Stephanie Q. ;
Giblon, Rachel E. ;
Langenfeld, Hannah E. ;
Alarcon, Graciela S. ;
Helmick, Charles G. ;
Crowson, Cynthia S. .
ANNALS OF THE RHEUMATIC DISEASES, 2022, 81 (09) :1260-1266
[9]  
Faraone Stephen V, 2008, P T, V33, P700
[10]   Epidemiology, etiology, detection, and treatment of autoantibody-associated congenital heart block in neonatal lupus [J].
Friedman D.M. ;
Rupel A. ;
Buyon J.P. .
Current Rheumatology Reports, 2007, 9 (2) :101-108