Investigating the Possible Link Between SLE and Preterm Birth

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that is estimated to affect over 200,000 Americans. Because SLE can affect numerous organs in the body, its symptoms vary wildly. Some patients may experience arthritis, hair loss, or skin rashes—particularly rashes that appear on the nose and cheeks, also known as a butterfly rash—while others suffer from headaches and even seizures.

Though SLE can affect anyone, women are considerably more at risk than men, likely due to hormonal differences. Estimates show women during their childbearing years account for roughly 9 out of 10 cases of SLE.

It is possible for women with SLE to have a healthy pregnancy, but childbearing with SLE can present major complications. One such complication is spontaneous preterm birth.

What Is Spontaneous Preterm Birth?

Spontaneous preterm birth occurs when a childbearing mother goes into unplanned labor before the 37^th week of pregnancy. Spontaneous preterm birth typically occurs in about 5 to 7 percent of births worldwide, though the incidence is higher in some underdeveloped counties.

The exact cause of spontaneous preterm birth is currently unknown, but according to a recent study, those with SLE are far more likely to experience it than those without SLE.

SLE and Its Connection to Preterm Birth

A study published in the American Journal of Obstetrics and Gynecology found that SLE can be associated with a heightened risk of spontaneous preterm birth. The study examined over 8,000 pregnancies in women with SLE through research articles published between 1995 and June 2021. It found that on average, 31 percent of the pregnancies resulted in preterm birth—14 percent of which were spontaneous and 16 percent were indicated.

As physicians with this information in mind, it’s critical to monitor patients with SLE closely, especially if they are expecting a child.

Steps to Avoiding Spontaneous Preterm Birth

Oftentimes, spontaneous preterm birth is a completely random phenomenon that may not be possible to prevent. However, expecting mothers—particularly ones with SLE—will want to follow best pregnancy practices in order to optimize their chances of having a healthy delivery. Those best practices include:

• Following a Healthy Diet: It’s imperative to consume whole, nutrient-dense foods while carrying a child. For this reason, patients are advised to stay away from processed foods high in sugars and saturated fats.
• Getting Regular Exercise: Staying active can be difficult while pregnant. However, light cardiovascular exercises like walking and swimming can go a long way in keeping the body strong even during pregnancy.
• Healthy Sleeping Habits: Lack of sleep can increase the risk of complications during pregnancy. For this reason, it’s advised to get at least the recommended seven to nine hours of sleep on a nightly basis.

While these best practices cannot completely ensure the prevention of preterm birth, they foster a healthy lifestyle that’s associated with significant health advantages.

What Lies Ahead?

Though there is a potential connection between SLE and preterm birth, additional research is still critical in understanding the correlation. As we continue enhancing our comprehension of preterm birth and its connection to SLE, so too will the patient guidelines, potentially leading to smoother, healthier pregnancies.

References:

Abheiden, C. N. H., Blomjous, B. S., Slaager, C., Landman, A. J. E. M. C., Ket, J. C. F., Salmon, J. E., Buyon, J. P., Heymans, M. W., de Vries, J. I. P., Bultink, I. E. M., & de Boer, M. A. (2024, March 26). Systemic lupus erythematosus is associated with an increased frequency of spontaneous preterm births: Systematic review and meta-analysis. American journal of obstetrics and gynecology. https://pubmed.ncbi.nlm.nih.gov/38492714/

SZ;, Y. W. (2004, August). Gender differences in systemic lupus erythematosus. Gender medicine. https://pubmed.ncbi.nlm.nih.gov/16115579/

R;, M. (n.d.). Spontaneous preterm birth, a clinical dilemma: Etiologic, pathophysiologic and genetic heterogeneities and racial disparity. Acta obstetricia et gynecologica Scandinavica. https://pubmed.ncbi.nlm.nih.gov/18568457/#:~:text=Preterm%20labor%20leading%20to%20preterm,significantly%20higher%20in%20developing%20countries.