Impact of low-dose acetylsalicylic acid on pregnancy outcome in systemic lupus erythematosus: results from a multicentre study
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Impact of low-dose acetylsalicylic acid on pregnancy outcome in systemic lupus erythematosus: results from a multicentre study. / Tani, Chiara; Zucchi, Dina; Haase, Isabell; Gerosa, Maria; Larosa, Maddalena; Cavagna, Lorenzo; Bortoluzzi, Alessandra; Crisafulli, Francesca; Mucke, Johanna; Strigini, Francesca A L; Baglietto, Laura; Fornili, Marco; Monacci, Francesca; Elefante, Elena; Erra, Roberta; Bellis, Elisa; Padovan, Melissa; Andreoli, Laura; Coletto, Lavinia Agra; Zanframundo, Giovanni; Govoni, Marcello; Iaccarino, Luca; Tincani, Angela; Doria, Andrea; Fischer-Betz, Rebecca; Mosca, Marta.
In: LUPUS SCI MED, Vol. 9, No. 1, e000714, 06.2022.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of low-dose acetylsalicylic acid on pregnancy outcome in systemic lupus erythematosus: results from a multicentre study
AU - Tani, Chiara
AU - Zucchi, Dina
AU - Haase, Isabell
AU - Gerosa, Maria
AU - Larosa, Maddalena
AU - Cavagna, Lorenzo
AU - Bortoluzzi, Alessandra
AU - Crisafulli, Francesca
AU - Mucke, Johanna
AU - Strigini, Francesca A L
AU - Baglietto, Laura
AU - Fornili, Marco
AU - Monacci, Francesca
AU - Elefante, Elena
AU - Erra, Roberta
AU - Bellis, Elisa
AU - Padovan, Melissa
AU - Andreoli, Laura
AU - Coletto, Lavinia Agra
AU - Zanframundo, Giovanni
AU - Govoni, Marcello
AU - Iaccarino, Luca
AU - Tincani, Angela
AU - Doria, Andrea
AU - Fischer-Betz, Rebecca
AU - Mosca, Marta
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/6
Y1 - 2022/6
N2 - OBJECTIVE: It is still a matter of debate whether low-dose acetylsalicylic acid (LDASA) should be prescribed to all patients with SLE during pregnancy. This study aimed at investigating the impact of LDASA on pregnancy outcomes in patients with SLE without history of renal involvement and without antiphospholipid antibodies (aPL).METHODS: This is a retrospective analysis of prospectively monitored pregnancies at seven rheumatology centres. Previous/current renal involvement and aPL positivity were the exclusion criteria. Adverse pregnancy outcome (APO) is the composite outcome of the study and included proteinuric pre-eclampsia, preterm delivery <37 weeks, small-for-gestational age infant, low birth weight <2500 g, intrauterine growth restriction and intrauterine fetal death after 12 weeks of gestation of a morphologically normal fetus.RESULTS: 216 pregnancies in 187 patients were included; 82 pregnancies (38.0%) were exposed to LDASA treatment. No differences in terms of age at conception, disease duration, clinical manifestations, comorbidities and disease flare during pregnancy were observed between patients taking LDASA and those who did not take LDASA during pregnancy. APO was observed in 65 cases (30.1%), including 13 cases (6.1%) of pre-eclampsia. The incidence of all complications was similar in the two groups. However, it is interesting to note that pre-eclampsia had lower frequency in patients taking LDASA versus those not taking LDASA (2.4% vs 8.3%, p=0.14).CONCLUSIONS: In pregnant patients with SLE without renal involvement and were aPL-negative, there is a low risk of severe obstetric complications, such as early pre-eclampsia. LDASA treatment does not provide a statistically significant advantage over these complications. However, a careful individual risk-benefit balance is warranted.
AB - OBJECTIVE: It is still a matter of debate whether low-dose acetylsalicylic acid (LDASA) should be prescribed to all patients with SLE during pregnancy. This study aimed at investigating the impact of LDASA on pregnancy outcomes in patients with SLE without history of renal involvement and without antiphospholipid antibodies (aPL).METHODS: This is a retrospective analysis of prospectively monitored pregnancies at seven rheumatology centres. Previous/current renal involvement and aPL positivity were the exclusion criteria. Adverse pregnancy outcome (APO) is the composite outcome of the study and included proteinuric pre-eclampsia, preterm delivery <37 weeks, small-for-gestational age infant, low birth weight <2500 g, intrauterine growth restriction and intrauterine fetal death after 12 weeks of gestation of a morphologically normal fetus.RESULTS: 216 pregnancies in 187 patients were included; 82 pregnancies (38.0%) were exposed to LDASA treatment. No differences in terms of age at conception, disease duration, clinical manifestations, comorbidities and disease flare during pregnancy were observed between patients taking LDASA and those who did not take LDASA during pregnancy. APO was observed in 65 cases (30.1%), including 13 cases (6.1%) of pre-eclampsia. The incidence of all complications was similar in the two groups. However, it is interesting to note that pre-eclampsia had lower frequency in patients taking LDASA versus those not taking LDASA (2.4% vs 8.3%, p=0.14).CONCLUSIONS: In pregnant patients with SLE without renal involvement and were aPL-negative, there is a low risk of severe obstetric complications, such as early pre-eclampsia. LDASA treatment does not provide a statistically significant advantage over these complications. However, a careful individual risk-benefit balance is warranted.
KW - Aspirin/adverse effects
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Lupus Erythematosus, Systemic/complications
KW - Pre-Eclampsia/drug therapy
KW - Pregnancy
KW - Pregnancy Outcome/epidemiology
KW - Retrospective Studies
U2 - 10.1136/lupus-2022-000714
DO - 10.1136/lupus-2022-000714
M3 - SCORING: Journal article
C2 - 35701044
VL - 9
JO - LUPUS SCI MED
JF - LUPUS SCI MED
SN - 2053-8790
IS - 1
M1 - e000714
ER -
