Evidence map›Paper›PMID 41571408›Full record

ArticleLupus science & medicine2026

Balancing stringency and feasibility: comparative value of disease-activity measures to predict pregnancy outcomes in systemic lupus erythematosus.

Yanran Chen, Siju Lin, Minjun Wang, Qin Huang, Jingyi Xie, Cuilian Liu, Qiu Hu, Zirui Zhou, Tianzhi Tian, Xiaoping Hong and 1 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Lupus science & medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yanran ChenDepartment of Rheumatology and Immunology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China.
Siju LinDepartment of Rheumatology and Immunology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China.ORCID 0009-0003-6344-5306
Minjun WangDepartment of Rheumatology and Immunology, The First Affiliated Hospital (Shenzhen People's Hospital), School of Medicine, Southern University of Science and Technology, Shenzhen, China.
Qin HuangDepartment of Rheumatology and Immunology, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, China.
Jingyi XieDepartment of Rheumatology and Immunology, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, China.
Cuilian LiuDepartment of Rheumatology and Immunology, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, China.
Qiu HuDepartment of Rheumatology and Immunology, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, China.
Zirui ZhouDepartment of Rheumatology and Immunology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China.
Tianzhi TianDepartment of Rheumatology and Immunology, The First Affiliated Hospital (Shenzhen People's Hospital), School of Medicine, Southern University of Science and Technology, Shenzhen, China.
Xiaoping HongDepartment of Rheumatology and Immunology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China liu_dz2001@sina.com hong_xiaoping@hotmail.com.
Dongzhou LiuDepartment of Rheumatology and Immunology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China liu_dz2001@sina.com hong_xiaoping@hotmail.com.ORCID 0000-0003-3766-6562

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare preconception disease-activity indices-systemic lupus erythematosus Disease Activity Score low disease activity (SLE-DAS LDA), lupus low disease activity state (LLDAS) and SLE-DAS remission-with Definitions of Remission in SLE (DORIS) remission in predicting adverse maternal and fetal outcomes among pregnant women with SLE.

methodsThis retrospective cohort study included 202 pregnancies in 196 women with SLE managed at Shenzhen People's Hospital between January 2017 and December 2024. Preconception disease activity was categorised using SLE-DAS, LLDAS and DORIS remission criteria. Main outcomes were maternal flares and fetal outcomes, including spontaneous abortion, therapeutic abortion, total fetal loss, preterm delivery and small for gestational age (SGA). Predictive accuracies of indices were compared.

resultsPreconceptionally, 127 pregnancies (62.8%) met LLDAS, 131 (64.9%) met SLE-DAS LDA and 78 (38.6%) achieved DORIS remission. Compared with higher disease activity, SLE-DAS LDA was associated with fewer maternal flares (22.1% vs 45.1%) and therapeutic abortions (6.4% vs 15.7%). LLDAS was associated with lower rates of flare (21.3% vs 45.3%), therapeutic abortion (7.9% vs 17.3%), total fetal loss (19.7% vs 34.2%) and preterm delivery (22.0% vs 25.3%). SLE-DAS and DORIS remission performed similarly for maternal outcomes, while DORIS remission correlated more strongly with favourable fetal outcomes, including lower total fetal loss (15.4% vs 31.5%), preterm delivery (15.4% vs 28.2%) and SGA (9.0% vs 19.4%). Multivariable analyses confirmed that achieving these disease-activity states preconception independently protected against total fetal loss, maternal flare and therapeutic abortion. LLDAS was the best overall predictor, while SLE-DAS LDA was the most attainable and predictive for maternal complications.

conclusionSLE-DAS LDA effectively predicts maternal complication, while LLDAS better identifies fetal risk. Remission offers similar protection but is less attainable, suggesting LDA suffices for conception planning. Optimising preconception disease control remains essential and warrants multicentre validation.

Indexed as

Lupus Erythematosus, SystemicPregnancy ComplicationsPregnancy OutcomeAbortion, SpontaneousAbortion, TherapeuticAdultFeasibility StudiesFemaleHumansPregnancyPremature BirthRemission InductionRetrospective StudiesSeverity of Illness IndexDisease ActivityOutcome Assessment, Health CareSeverity of Illness IndexSystemic Lupus Erythematosus

Identifiers

PMID41571408
PMCPMC12829344

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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.