ArticleArthritis research & therapy2020
Low frequency of flares during pregnancy and post-partum in stable lupus patients.
Article in Arthritis research & therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Risk and protective factors of disease flare during pregnancy in systemic lupus erythematosus: a systematic review and meta-analysis.Clinical rheumatology · 2025Pooled it
- Sex steroids and autoimmune rheumatic diseases: state of the art.Nature reviews. Rheumatology · 2020Pooled it
- Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance.Military Medical Research · 2026Review
- The impact of early pregnancy disease control in systemic lupus erythematosus patients receiving comprehensive pharmaceutical care on pregnancy outcomes and offspring long-term health.BMC pregnancy and childbirth · 2025Article
- The fourth trimester and challenges for the lupus patient.EULAR rheumatology open · 2025Review
- Systemic Lupus Erythematosus With Cardiac Tamponade and Myocardial Edema in the Early Postpartum Period.JACC. Case reports · 2025Article
- The conditions that patients with systemic lupus erythematosus should fulfill before pregnancy to optimize outcomes: a large-scale multicenter cohort study from China.Arthritis research & therapy · 2025Article
- Peripartum maternal outcomes in individuals with systemic lupus erythematosus in a real-world electronic health record cohort.Seminars in arthritis and rheumatism · 2025Article
- Impact of Systemic Lupus Erythematosus on Conception: Insights into Infertility, Fertility Preservation, Assisted Reproductive Technology, and Pregnancy Outcomes.Seminars in reproductive medicine · 2024Review
- Association of Anti-Ro/SSA and Anti-La/SSB Autoantibodies With Pregnancy Outcome in the General Population.Materia socio-medica · 2024Article
- Lupus nephritis: management challenges during pregnancy.Frontiers in nephrology · 2024Review
- 2022 Chinese guideline for the management of pregnancy and reproduction in systemic lupus erythematosus.Rheumatology and immunology research · 2023Review
- Fetal and maternal morbidity in pregnant patients with Lupus: a 10-year US nationwide analysis.RMD open · 2023Article
- Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome.Journal of clinical medicine · 2022Article
- Postnatal Care of Woman with Rheumatic Diseases.Advances in therapy · 2020Review
- Adverse Pregnancy Outcomes after Multi-Professional Follow-Up of Women with Systemic Lupus Erythematosus: An Observational Study from a Single Centre in Sweden.Journal of clinical medicine · 2020Article
- Outcomes of pregnancy and associated factors in sub-Saharan African women with systemic lupus erythematosus: a scoping review.Lupus science & medicine · 2020Article
- Postpartum Pulmonary-Renal Syndrome with Thrombotic Microangiopathy in Systemic Lupus Erythematosus.Indian journal of nephrologyArticle
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundLupus patients are at risk for pregnancy loss, and it has been generally accepted that women with SLE should have low disease activity prior to conception. However, there are conflicting results regarding the effect of pregnancy on SLE flares. This study aims to identify predictors of flares during and after pregnancy in SLE patients with inactive or stable disease activity during the first trimester and to characterize and estimate the frequency of post-partum flares in these patients.
methodsSLE patients in the multicenter, prospective PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study were evaluated for flares during and after pregnancy using the SELENA-SLEDAI Flare Index. Flares during pregnancy were assessed in all 384 patients and post-partum flares in 234 patients with study visits 2-6 months post-partum. Logistic regression models were fit to the data to identify independent risk factors for flare.
resultsDuring pregnancy, 20.8% of patients had mild/moderate flares and 6.25% had severe. Post-partum, 27.7% of patients had mild/moderate flares and 1.7% had severe. The mild flares rarely required treatment. Younger age, low C4 and higher PGA at baseline were independently associated with higher risk of having at least one mild/moderate or severe flare during pregnancy. Older patients were at decreased risk of flare, as well as those with quiescent disease at baseline. No variables evaluated at baseline or the visit most proximal to delivery was significantly associated with risk of flare post-partum. Medications were not associated with flare during or after pregnancy.
conclusionIn patients with inactive or stable mild disease activity at the time of conception, lupus disease flares during and after pregnancy are typically mild and occur at similar rates. Flares during pregnancy are predicted by the patients' age and clinical and serological activity at baseline.
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