609 Pregnancy Outcomes in Systemic Lupus Erythematosus (SLE): Data from a Multiethnic, Multinational Latin American Cohort

Background Obstetric morbidity (OM) is higher in SLE women than in healthy ones. Few data on SLE pregnancy outcomes in Latin America (LA) have been reported. Objectives To study SLE pregnancy outcomes in LA. Methods GLADEL 2.0 is an observational prevalent/incident cohort started in 2019. To date, 43 centers from 10 LA countries have enrolled 1030 SLE patients (1982/1997 ACR or SLICC criteria). Women with ≥1 pregnancy were included. Past and ongoing (6, 12, 24 months follow-up) OM (miscarriages, fetal deaths, preeclampsia, prematurity, neonatal lupus) were evaluated. Results At inclusion, 329 women have had at least one pregnancy [median (IQR): 2 (1–3)]: table 1. Of them, 293 (89.1%) had ≥1 live birth and 183 (55.6%) developed OM. Preeclampsia occurred in 49 (14.9%). Among 71 (21.6%) women with anti-SS-A(Ro)/SS-B(La) antibodies, 3 (4.2%) developed neonatal lupus (no cardiac involvement). Antiphospholipid syndrome (APS) was associated with higher risk of OM (52.2% vs 10.0%; p< 0.001). Of the 755 pregnancies reported, 551 (73.0%) resulted in live births, of which 79 (14.3%) were premature. The remaining pregnancies ended in 178 (23.6%) miscarriages and 41 (5.4%) fetal deaths. During 2-follow-up years (figure 1), 24 singles pregnancies occurred. All were under antimalarials; 16 (66.7%) resulted in live births, 4 (25.0%) premature; 12 (50.0%) developed OM. There were seven (29.2%) miscarriages and one fetal loss (4.2%) related to severe preeclampsia. One cholestasis gravidarum (4.2%) lead to prematurity. There were no new cases of neonatal lupus. Conclusion In GLADEL 2.0 cohort, around half of the studied women presented OM being frequently related to APS. Miscarriages, prematurity, preeclampsia and fetal deaths were the most common pregnancy complications. The incidence of neonatal lupus was lower than previously reported.1 Reference Cimaz R, et al. Incidence and spectrum of neonatal lupus erythematosus: a prospective study of infants born to mothers with anti-Ro autoantibodies. J Pediatr 2003;142:678–83. Lay summary Pregnancy in patients with lupus carries increased risk to both the mother and baby. Black and Hispanic patients are the most seriously affected, but pregnancy in lupus is not well understood in Latin American patients. Results from a multiethnic, multinational Latin American cohort of patients with lupus showed that miscarriages, prematurity, preeclampsia, and fetal deaths were the most common pregnancy complications. The results of this study highlight the great unmet need in improved care of patients with lupus during pregnancy to protect the health of the mother and baby. Disclosure of interest Rosa Maria Serrano Morales: None declared, Romina Nieto: None declared, Rosana Quintana: None declared, Paula Alba: None declared, Sabrina POrta: None declared, Lucia Hernández: None declared, Guillermo Berbotto: None declared, Verónica Inés Bellomio: None declared, Nílzio da Silva: None declared, Odirlei Monticielo: None declared, Fernando Cavalcanti: None declared, Francinne Machado Ribeiro: None declared, Eduardo Borba: None declared, Eloisa Bonfa: None declared, loreto massardo: None declared, Gustavo Aroca Martínez: None declared, Andrés Cadena Bonfanti: None declared, GERARDO QUINTANA LOPEZ: None declared, Mario Javier MORENO ALVAREZ: None declared, Jorge Antonio Esquivel Valerio: None declared, Isabel Acosta-Colman: None declared, Astrid Paats: None declared, CLAUDIA MORA: None declared, Marina Scolnik: None declared, Diana Fernández Ávila: None declared, Carmen Funes Soaje: None declared, Veronica Saurit: None declared, Mercedes García: None declared, Eduardo Kerzberg: None declared, Graciela Gomez: None declared, Cecilia Pisoni: None declared, Edgard Reis Neto: None declared, Iris Guerra Herrera: None declared, Oscar Neira: None declared, Carlos Cañas: None declared, Miguel A Saavedra: None declared, Margarita Portela: None declared, Hilda Fragoso loyo: None declared, Luis Humberto Silveira Torre: None declared, Ignacio Garcia-De La Torre: None declared, Manuel F. Ugarte-Gil: None declared, Armando Calvo Quiroz: None declared, Roberto Muñoz Louis: None declared, RICARDO ROBAINA: None declared, Vicente Juarez: None declared, ALVARO DANZA: None declared, Carlos Enrique Toro Gutierrez: None declared, Carlos Abud- Mendoza: None declared, Ana Malvar: None declared, Graciela S Alarcon: None declared, Ashley Orillion Shareholder of: Janssen Research & Development, Spring House, USA, Speakers bureau: Janssen Research & Development, Spring House, USA, Paid instructor for: Janssen Research & Development, Spring House, USA, Consultant of: Janssen Research & Development, Spring House, USA, Grant/research support from: Janssen Research & Development, Spring House, USA, Employee of: Janssen Research & Development, Spring House, USA, Urbano Sbarigia Shareholder of: Janssen Pharmaceutica NV, Beerse, Belgium, Speakers bureau: Janssen Pharmaceutica NV, Beerse, Belgium, Paid instructor for: Janssen Pharmaceutica NV, Beerse, Belgium, Consultant of: Janssen Pharmaceutica NV, Beerse, Belgium, Grant/research support from: Janssen Pharmaceutica NV, Beerse, Belgium, Employee of: Janssen Pharmaceutica NV, Beerse, Belgium, Federico Zazzetti Shareholder of: Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA;, Speakers bureau: Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA;, Paid instructor for: Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA;, Consultant of: Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA;, Grant/research support from: Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA;, Employee of: Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA;, Guillermo Pons-Estel: None declared, Bernardo Pons-Estel: None declared. Johnson, Horsham, PA, USA;, Guillermo Pons-Estel: None declared, Bernardo Pons-Estel: None declared. Johnson, Horsham, PA, USA;, Guillermo Pons-Estel: None declared, Bernardo Pons-Estel: None declared.