{
  "abstract": "Objectives To assess the rate of second pregnancy and the recurrence of adverse pregnancy outcomes (APOs) in women with SLE compared to women from the general obstetric population.Methods This nationwide population-based cohort study used Swedish registers (2003-2022) to identify all women with SLE who had their first singleton liveborn delivery after SLE diagnosis. Women without SLE from the general population were randomly selected and matched on birth year, sex, and residence with SLE cases. We examined the time from delivery date of the first pregnancy to the last menstrual period date of the second pregnancy in women included during 2003-2020, to allow for at least 2 years of follow-up to capture second pregnancies. We assessed the recurrence of any APO, preeclampsia, and preterm delivery, considered separately, in women who had both a first and a second pregnancy during 2003-2022. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for second pregnancy, and modified Poisson models derived risk ratios (RR) for APO recurrence, comparing women with SLE to those without SLE. Analyses were adjusted for maternal age, education, BMI, smoking, APOs, and C-section.Results Second pregnancy rates were analysed for 543 women with SLE and 17,218 women without SLE (overall mean age at first delivery 30 years). Over a median follow-up of 2.3 years, the incidence rate of second pregnancy was 156 and 176 per 1,000 person-years for SLE and non-SLE, respectively (adjusted HR 0.89 [0.80-0.99]). The adjusted HRs (SLE vs. non-SLE) were 0.78 (0.63-0.96) in women experiencing any APO in the first delivery and 0.94 (0.83-1.06) in women not experiencing any APOs. The recurrence risk of APOs was higher in women with SLE vs. non-SLE (preeclampsia: 31.6% vs. 19.8%, adjusted RR 1.38 [0.77-2.47]; preterm delivery: 36.8% vs. 15.6%, RR 2.31 [1.52-3.53]; any APO: 42.3% vs. 26.9%, RR 1.54 [1.18-2.00]).Conclusions Women with SLE have a lower rate of second pregnancy vs. the general population, especially when experiencing an APO in the first pregnancy. The recurrence risk of APOs is higher in women with SLE, suggesting closer and individualized reproductive counseling, support, and monitoring before and during pregnancy.",
  "authors": [
    {
      "affiliations": [
        "Karolinska Institutet, Department of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital, Stockholm, Sweden"
      ],
      "name": "Aleksandra Antovic"
    },
    {
      "affiliations": [
        "Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Division, Stockholm, Sweden"
      ],
      "name": "Ngoc V Nguyen"
    },
    {
      "affiliations": [
        "Karolinska Institutet, Department of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital, Stockholm, Sweden"
      ],
      "name": "Iva Gunnarsson"
    },
    {
      "affiliations": [
        "Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Division, Stockholm, Sweden",
        "Karolinska University Hospital, Department of Women’s Health, Division of Obstetrics, Stockholm, Sweden"
      ],
      "name": "Anna Sandström"
    },
    {
      "affiliations": [
        "Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Division, Stockholm, Sweden"
      ],
      "name": "Elizabeth V Arkema"
    }
  ],
  "title": "PT6:08 Second pregnancy rates and recurrence of adverse pregnancy outcomes in women with systemic lupus erythematosus: a nationwide population-based cohort study",
  "uid": "8cc6aaed-6c5f-5360-9078-bfbbec2bca81"
}