Poor preconceptional CV health tied to preterm birth, SGA in women with SLE
An association exists between poor/intermediate preconceptional cardiovascular (CV) health and pregnancy outcomes of preterm birth and small for gestational age (SGA) infants among women with systemic lupus erythematosus (SLE), suggests a recent study.
A total of 309 live births were analysed, with 95 being preterm (31 percent). Eighteen percent of the 293 pregnancies with birth weight data were SGA. Ideal body mass index (BMI) was reported in 56 percent of pregnancies, while total cholesterol and blood pressure (BP) were reported in 85 percent and 51 percent, respectively.
When adjusted for race and prednisone use, an association was found between intermediate BMI and lower odds of SGA (odds ratio [OR], 0.26; 95 percent CI, 0.11–0.63). Poor/intermediate total cholesterol correlated with an increased risk of preterm birth (OR, 2.21; 1.06–4.62), while poor/intermediate BP correlated with lower gestational age at birth (β −0.96; –1.62 to –0.29).
“Efforts to maintain BMI, total cholesterol and BP within the recommended ideal range prior to pregnancy is important to improve pregnancy outcomes in women with SLE,” the authors said.
This study enrolled patients in the Hopkins Lupus Pregnancy Cohort to assess the effects of preconceptional CV health on pregnancy outcomes in women with SLE. CV health (ideal, intermediate or poor) based on the American Heart Association definitions was determined using BMI, total cholesterol and BP in the most recent clinic visit prior to conception or first trimester.
Measured outcomes were preterm birth, gestational age at birth and SGA. The authors used multivariable linear and logistic regression models with generalized estimating equations to examine the association of each CV health factor and outcome.