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Association of Rheumatologic Disease With Preeclampsia

Adam J. Wolfberg, MD, MPH^*, Aviva Lee-Parritz, MD, Allyson J. Peller, MPH and Ellice S. Lieberman, MD, DrPH^¶

From the *Department of Obstetrics and Gynecology, Brigham and Women's Hospital, and Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston; Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston; Genetics and Teratology Unit, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston; and ¶Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Address reprint requests to: Adam Wolfberg, MD, MPH, Department of OB/GYN, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; e-mail: awolfberg{at}partners.org.

OBJECTIVE: To determine whether maternal rheumatologic disease is associated with an increased risk of adverse obstetric or neonatal outcomes.

METHODS: Using an institutional database, we identified all women with diagnosed rheumatologic disease (n = 114) who delivered a baby at our institution during a 33-month period. We compared the incidence of adverse obstetric and neonatal outcomes among these women with the incidence among women without rheumatologic diseases (n = 18,534).

RESULTS: Women with rheumatologic diseases were more likely to have preeclampsia than women without rheumatologic disease (8.8% versus 2.3%, P < .001) Women with rheumatologic diseases were also at increased risk of preterm delivery (15.2% versus 7.8%, P = .002) and small-for-gestational-age infants (8.0% versus 3.1%, P = .001) compared with women without rheumatologic disease.

CONCLUSION: The finding that women with rheumatologic diseases are at increased risk of adverse obstetric outcomes suggests a need for heightened clinical vigilance and further research into the common pathophysiologic correlates.

LEVEL OF EVIDENCE: II-2

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