This preprint is under consideration at Arthritis Research & Therapy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Takuya Kotani
Osaka Medical College hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2190-0780
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background. This study aimed to clarify predictors of preterm birth in pregnancy of women with systemic lupus erythematosus (SLE). We investigated the predictors of preterm birth before pregnancy from the perspective of the importance of preconception care.
Methods. We analysed foetal outcomes of 108 pregnancies in 74 SLE patients. We compared pre-pregnancy clinical characteristics and disease activity in these women between the preterm birth and full-term birth groups to select predictive factors for preterm birth before pregnancy.
Results. Eighty-three of 108 pregnancies resulted in live births, of which 27 (25.0%) were preterm births. Pre-pregnancy serum complement 3 (C3) level was significantly lower in the preterm birth group (77.0 mg/dl) than the full-term birth group (87.5 mg/dl) (P = 0.029). Multivariate analysis identified history of lupus nephritis (odds ratio: 5.734, 95% CI: 1.568-21.010, P = 0.008) and low C3 level (<85 mg/dl) at pre-pregnancy (odds ratio: 4.498, 95% CI: 1.296-15.616, P = 0.018) as risk factors for preterm birth. The greater the number of these risk factors, the higher was the preterm birth rate (P = 0.0007). In the case of SLEDAI score ≤ 4, the preterm birth rate was higher in the pre-pregnancy low C3 group (<85 mg / dl) (42.1%) than in the high C3 group (C3 ≥ 85 mg / dl) (14.7%) (P = 0.018).
Conclusion. Preconception care improves the outcome of SLE pregnancy. Especially for patients with a history of LN, treatment management focusing on pre-pregnancy serum complement titers is very important.
Keywords
systemic lupus erythematosus, pregnancy, preconception care, preterm birth, serum complement 3 level
Figure 1
Figure 2
Figure 3
Figure 4
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 23 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 27 Mar, 2021
Review #2 received
Received 25 Mar, 2021
Reviewer #2 agreed
On 16 Mar, 2021
Editor assigned
On 16 Mar, 2021
Review #? received
Received 16 Mar, 2021
Reviewer #1 agreed
On 16 Mar, 2021
Review #1 received
Received 16 Mar, 2021
Reviewers invited
Invitations sent on 16 Mar, 2021
Editor invited
On 16 Mar, 2021
Submission checks complete
On 15 Mar, 2021
First submitted
On 11 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Internal Medicine
Learn more about our company.
This preprint is under consideration at Arthritis Research & Therapy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Takuya Kotani
Osaka Medical College hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2190-0780
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 23 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 27 Mar, 2021
Review #2 received
Received 25 Mar, 2021
Reviewer #2 agreed
On 16 Mar, 2021
Editor assigned
On 16 Mar, 2021
Review #? received
Received 16 Mar, 2021
Reviewer #1 agreed
On 16 Mar, 2021
Review #1 received
Received 16 Mar, 2021
Reviewers invited
Invitations sent on 16 Mar, 2021
Editor invited
On 16 Mar, 2021
Submission checks complete
On 15 Mar, 2021
First submitted
On 11 Mar, 2021
Subject Areas
Internal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background. This study aimed to clarify predictors of preterm birth in pregnancy of women with systemic lupus erythematosus (SLE). We investigated the predictors of preterm birth before pregnancy from the perspective of the importance of preconception care.
Methods. We analysed foetal outcomes of 108 pregnancies in 74 SLE patients. We compared pre-pregnancy clinical characteristics and disease activity in these women between the preterm birth and full-term birth groups to select predictive factors for preterm birth before pregnancy.
Results. Eighty-three of 108 pregnancies resulted in live births, of which 27 (25.0%) were preterm births. Pre-pregnancy serum complement 3 (C3) level was significantly lower in the preterm birth group (77.0 mg/dl) than the full-term birth group (87.5 mg/dl) (P = 0.029). Multivariate analysis identified history of lupus nephritis (odds ratio: 5.734, 95% CI: 1.568-21.010, P = 0.008) and low C3 level (<85 mg/dl) at pre-pregnancy (odds ratio: 4.498, 95% CI: 1.296-15.616, P = 0.018) as risk factors for preterm birth. The greater the number of these risk factors, the higher was the preterm birth rate (P = 0.0007). In the case of SLEDAI score ≤ 4, the preterm birth rate was higher in the pre-pregnancy low C3 group (<85 mg / dl) (42.1%) than in the high C3 group (C3 ≥ 85 mg / dl) (14.7%) (P = 0.018).
Conclusion. Preconception care improves the outcome of SLE pregnancy. Especially for patients with a history of LN, treatment management focusing on pre-pregnancy serum complement titers is very important.
Figure 1
Figure 2
Figure 3
Figure 4
Loading...