ArticleBMC pregnancy and childbirth2025
The impact of early pregnancy disease control in systemic lupus erythematosus patients receiving comprehensive pharmaceutical care on pregnancy outcomes and offspring long-term health.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the impact of early pregnancy disease activity on pregnancy outcomes and long-term offspring health in patients with systemic lupus erythematosus (SLE) under a multidisciplinary model that incorporates continuous pharmaceutical care.
methodsThis retrospective cohort study included pregnant patients with SLE who attended the multidisciplinary immunology- focused pregnancy clinic at our hospital and received full-course pharmaceutical care between October 2018 and October 2022. Patients were stratified into active and inactive SLE groups based on SLEDAI scores during the first 10 weeks of gestation. Baseline characteristics, obstetric complications, and fetal outcomes were compared between the groups. Offspring were followed for a minimum of 24 months to evaluate growth parameters and the incidence of autoimmune, allergic, or neurodevelopmental disorders.
resultsA total of 137 pregnancies were included (30 in the active group and 107 in the inactive group). Pharmacists were involved throughout the care process, participating in preconception risk assessment, gestational medication optimisation, and adherence management. The active group demonstrated significantly different outcomes, with higher rates of pregnancy loss (43.3% vs. 11.2%, P < 0.001), pregnancy complications (83.3% vs. 48.6%, P < 0.001), and lupus nephritis (23.3% vs. 7.5%, P < 0.05) They also required high-dose prednisone more frequently (P = 0.041). Conversely, the active group had significantly lower live birth rates (60.0% vs. 87.9%, P < 0.001), full-term delivery rates (43.3% vs. 76.6%, P < 0.001), and favourable 5-minute Apgar scores (76.5% vs. 100.0%, P < 0.001). Among the 112 children followed for 24 months, no major birth defects, autoimmune diseases or neurodevelopmental abnormalities were observed. The inactive group reported 4 cases of visual abnormalities and 2 cases of asthma, while 1 case of asthma was documented in the active group.
conclusionPharmacists, as part of the multidisciplinary team, can provide comprehensive pharmaceutical care for pregnant patients with SLE. Both active and inactive SLE groups show risks of adverse pregnancy outcomes, with maternal and fetal outcomes being better in the inactive SLE group than in the active SLE group.
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