ArticleAnnals of the rheumatic diseases2018
Effect of pregnancy on disease flares in patients with systemic lupus erythematosus.
Article in Annals of the rheumatic diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 6 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- The influence of hydroxychloroquine on the risk of pre-eclampsia, hypertension, and premature delivery in patients with systemic lupus erythematosus during pregnancy: a meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Systemic Lupus Erythematosus in Pregnancy.Medical sciences (Basel, Switzerland) · 2025Pooled it
- Risk and protective factors of disease flare during pregnancy in systemic lupus erythematosus: a systematic review and meta-analysis.Clinical rheumatology · 2025Pooled it
- Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus.Current rheumatology reviews · 2025Guideline
- Circulating prolactin levels and the effect of dopaminergic agonists in systemic lupus erythematosus: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Hydroxychloroquine in the pregnancies of women with lupus: a meta-analysis of individual participant data.Lupus science & medicine · 2022Pooled it
- Pregnancy outcomes in women with rheumatologic diseases and neurologic involvement.Rheumatology international · 2026Article
- Prevalence of neurological manifestations among pregnant and postpartum women in a tertiary hospital in Egypt: a descriptive cross-sectional study.Acta neurologica Belgica · 2026Article
- Early Leukocyte Profiles in Preterm Infants Born to Mothers with Systemic Lupus Erythematosus: An Exploratory Matched Cohort Study.Children (Basel, Switzerland) · 2026Article
- Fertility management and outcomes after CAR T-cell therapy: an international survey from the Cellular Therapy and Immunobiology working party of the European Society for Blood and Marrow Transplantation.EClinicalMedicine · 2026Article
- Fertility, pregnancy and lactation in women with systemic lupus erythematosus.Nature reviews. Rheumatology · 2026Review
- A clinical care pathway for managing pregnancy in patients with inflammatory arthritis.Clinical rheumatology · 2026Review
- Temporal trends in lupus pregnancy over four decades in a referral centre: pregnancy planning and hydroxychloroquine use are associated with improved outcomes.Rheumatology advances in practice · 2026Article
- Reply to: "Toward precision maternal care in systemic lupus erythematosus: Bridging data limitations and research gaps".Clinical rheumatology · 2025Article
- The fourth trimester and challenges for the lupus patient.EULAR rheumatology open · 2025Review
- Risk stratification and subgroup analysis of systemic lupus erythematosus patients with pregnancy: based on a 13-year multicenter cohort study.Clinical rheumatology · 2025Article
- Risk of preterm delivery and early pregnancy hydroxychloroquine use from a Californian lupus cohort.Lupus science & medicine · 2025Article
- Fibrin Monomer and Systemic Lupus Erythematosus Reactivation During Pregnancy: A Retrospective Study.Diseases (Basel, Switzerland) · 2025Article
- A textured clinical mosaic involving autoimmune calcific constrictive pericarditis: a case report.European heart journal. Case reports · 2025Article
- Infection vulnerability in pregnant women with and without systemic lupus erythematosus.Lupus · 2025Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
objectivePrior studies found conflicting results about whether lupus is likely to flare during or after pregnancy. Using a large cohort of pregnant and non-pregnant women with lupus, we estimated the effect of pregnancy on disease flares in systemic lupus erythematosus.
methodsData were collected in the Hopkins Lupus Cohort 1987-2015. Women aged 14-45 years with >1 measurement of disease activity were included. The time-varying exposures were classified as pregnancy, postpartum or non-pregnant/non-postpartum periods. Flares were defined as: (1) change in Physician Global Assessment (PGA)≥1 from previous visit and (2) change in Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI)≥4 from previous visit. A stratified Cox model estimated HRs with bootstrap 95% CIs.
resultsThere were 1349 patients, including 398 pregnancies in 304 patients. There was an increased rate of flare defined by PGA during pregnancy (HR: 1.59; 95% CI 1.27 to 1.96); however, this effect was modified by hydroxychloroquine (HCQ) use, with the HR of flares in pregnancy compared with non-pregnant/non-postpartum periods estimated to be 1.83 (95% CI 1.34 to 2.45) for patients with no HCQ use and 1.26 (95% CI 0.88 to 1.69) for patients with HCQ use. The risk of flare was similarly elevated among non-HCQ users in the 3 months postpartum, but not for women taking HCQ after delivery.
conclusionsOur study supports and extends previous findings that the incidence of flare is increased during pregnancy and within the 3 months postpartum. Continuing HCQ, however, appeared to mitigate the risk of flare during and after pregnancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.