Abstract 16604: Systemic Lupus Erythematosus and Pregnancy: An Analytical Review of Cardiovascular Disease and Obstetric Complications

Background Cardiovascular disease in pregnant patients with Systemic Lupus Erythematosus (SLE) is not well studied. Our objective is to study the prognostic implications of SLE in pregnancy in terms of cardiovascular disease (CVD) and obstetric complications.

Methods A retrospective cohort analysis was conducted using National Inpatient Sample 2016-2020. Cohorts of patients hospitalized for SLE, pregnancy and CVD were identified using respective ICD-10 codes. Multivariate logistic regression analysis was used to assess prognostic outcomes.

Results Among 898825 patients hospitalized for SLE, 30845 patients were pregnant. Out of these patients with SLE and pregnancy, 1710 patients had cardiovascular disease (prevalence 5.5%). Mean age for SLE patients with pregnancy and cardiovascular disease was 30 years, 36.7% were white, and 36.4% were African-American. SLE in pregnancy is associated with five folds higher odds of cardiovascular disease (OR 4.8, CI 4.3-5.5, p<0.001). The strongest association of SLE in pregnancy is with pericarditis (OR 77, CI 34.4-172, p<0.001), followed by myocarditis (OR 35, CI 3.9-312, p=0.001), pulmonary hypertension (OR 12.9, CI 8.6-17.5, p<0.001), ischemic heart disease (OR 9.3, CI 6.7-12.8, p<0.001), stroke (OR 9.3, CI 4.8-18, p<0.001) and congestive heart failure (OR 7.7, CI 5.16-11.5, p<0.001). Table 2 outlines the pregnancy outcomes and complications in SLE. SLE is associated with significantly lower odds of live birth (OR 0.35, CI 0.32-0.37, p<0.001). SLE is associated with significantly higher odds of pregnancy complications (Table 2).

Conclusion 5.5% of SLE patients with pregnancy have CVD. SLE in pregnancy is associated with five folds higher odds of cardiovascular disease with strongest association to pericarditis, followed by myocarditis, pulmonary hypertension, ischemic heart disease, and stroke. SLE in pregnancy is associated with lower odds of live birth and higher odds of obstetric complications.