title: Pregnancy outcomes among African-American patients with systemic lupus erythematosus compared with controls.
abstract: OBJECTIVE
  In a study of Gullah African-Americans, we compared pregnancy outcomes before and after systemic lupus erythematosus (SLE) diagnosis to controls to test whether there is a predisease state that negativelyaffects pregnancy outcomes.
  
  
  METHODS
  Cases and controls reporting at least one pregnancy were included. Controls were all Gullah African-American females. We collected demographic, socioeconomic and pregnancy data. We modelled pregnancy outcome associations with case status using multiple logistic regression to calculate ORs.
  
  
  RESULTS
  After adjustment for age, years of education, medical coverage and pregnancy number, compared with controls, cases were more likely to have any adverse outcome (OR 2.35, 95% CI 1.78 to 3.10), including stillbirth (OR 4.55, 95% CI 1.53 to 13.50), spontaneous abortion (OR 2.05, 95% CI 1.40 to 3.00), preterm birth (OR 2.58, 95% CI 1.58 to 4.20), low birth weight (OR 2.64, 95% CI 1.61 to 4.34) and preeclampsia (OR 1.80, 95% CI 1.08 to 3.01). The odds of adverse pregnancy outcomes all increased after SLE diagnosis compared with before diagnosis, even after adjustment for age, years of education, pregnancy number and medical coverage.
  
  
  CONCLUSIONS
  From a large cohort of African-American women, our findings suggest there may be a predisease state that predisposes to adverse pregnancy outcomes.
authors.affiliation: Division of Rheumatology, Department of Medicine , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: April
authors.initials: A
authors.lastname: Barnado
authors.affiliation: Department of Public Health Sciences , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Wheless
authors.affiliation: Division of Rheumatology, Department of Medicine , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Meyer
authors.affiliation: Division of Rheumatology, Department of Medicine , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Gilkeson
authors.affiliation: Division of Rheumatology, Department of Medicine , Medical University of South Carolina , Charleston, South Carolina , USA.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Kamen
keywords: pregnancy; systemic lupus erythematosus