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Disease Activity During Pregnancy and the First Year Postpartum in Women With Systemic Lupus Erythematosus
Author(s) -
Götestam Skorpen Carina,
Lydersen Stian,
Gilboe IngeMargrethe,
Skomsvoll Johan Fredrik,
Salvesen Kjell Å,
Palm Øyvind,
Koksvik Hege Suorza Svean,
Jakobsen Bente,
Wallenius Marianne
Publication year - 2017
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23102
Subject(s) - medicine , pregnancy , disease , systemic lupus erythematosus , observational study , obstetrics , postpartum period , prospective cohort study , longitudinal study , lupus erythematosus , immunology , pathology , antibody , genetics , biology
Objective Disease activity measured by validated methods has been sparsely examined during and after pregnancy in women with systemic lupus erythematosus (SLE). The aim of this study was to describe the longitudinal course of disease activity during pregnancy and the first year postpartum using the Lupus Activity Index in Pregnancy (LAI‐P). Methods RevNatus is a nationwide Norwegian prospective observational register including women diagnosed with inflammatory rheumatic diseases. LAI‐P is a modified version of the LAI, with a good ability to assess disease activity in pregnant women with SLE. These indexes were used to assess disease activity at 6 visits (in trimesters 1, 2, and 3, and at 6 weeks, 6 months, and 12 months postpartum). The longitudinal course of disease activity was analyzed using an ordinal logistic mixed model. Results A total of 757 visits (145 pregnancies) in women with SLE were included in the analysis. More than half (51.6%) of the disease activity scores indicated remission, and only 6.3% indicated moderate disease activity. The model showed a statistically significant and clinically relevant change in disease activity over time, and a higher disease activity 6 and 12 months postpartum compared to the third trimester and 6 weeks postpartum. Conclusion The majority of women had low or no disease activity at conception and during pregnancy, with higher disease activity at 6 and 12 months after delivery. This points to the importance of tight disease control not only before and during pregnancy but also in the first year postpartum.