Volume 16 Supplement 1

Lupus 2014: New Targets, New Approaches

Open Access

Adverse pregnancy outcomes and subsequent risk of cardiovascular disease in women with systemic lupus erythematosus

  • Pin Lin1,
  • Elisa Rhew1,
  • Roberta B Ness2,
  • Alan Peaceman1,
  • Alan Dyer1,
  • David McPherson3,
  • George T Kondos4,
  • Daniel Edmundowicz5,
  • Kim Sutton-Tyrrell6,
  • Trina Thompson6 and
  • Rosalind Ramsey-Goldman1Email author
Arthritis Research & Therapy201416(Suppl 1):A46

https://doi.org/10.1186/ar4662

Published: 18 September 2014

Background

Patients with systemic lupus erythematosus (SLE) are at increased risk for adverse pregnancy outcomes and cardiovascular disease (CVD). The objective of this exploratory study was to investigate the association between a history of adverse pregnancy outcomes and subsequent risk of subclinical CVD assessed by imaging studies and verified clinical CVD events in 129 women with SLE.

Methods

The occurrence of adverse pregnancy outcomes, specifically pre-eclampsia, preterm birth, and low birth weight, was ascertained by questionnaire. Subclinical CVD was assessed by coronary artery calcium (CAC) as measured by electron beam computed tomography (EBCT) and carotid plaque measured by B-mode ultrasound. Clinical CVD events were verified by medical record review. Logistic regression was used to estimate the association of pregnancy complications with occurrence of subclinical and clinical CVD with a priori adjustment for age, which is associated with CVD and SLE disease duration as a measure of SLE disease burden.

Results

Fifty-six women reported at least one pregnancy complication while 73 had none. Twenty-six women had at least one pregnancy complicated by pre-eclampsia and were more likely to have a CAC score ≥10 (adjusted odds ratio (OR) = 3.7; 95% confidence interval (CI): 1.2, 11.9), but the presence of plaque was not associated with this pregnancy complication (OR = 1.1; 95% CI: 0.4, 2.8). Low birth weight and preterm birth were not associated with CAC or plaque.

Conclusions

SLE patients with a history of pre-eclampsia had a higher rate of subclinical CVD as measured by CAC score. Future studies are needed to confirm the relationship between adverse pregnancy outcomes and subsequent subclinical CVD and clinical CVD events.

Authors’ Affiliations

(1)
Northwestern University, Feinberg School of Medicine
(2)
The University of Texas, School of Public Health
(3)
University of Texas Health Science Center
(4)
University of Illinois
(5)
Temple University School of Medicine
(6)
University of Pittsburgh, Graduate School of Public Health

Copyright

© Lin et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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