title: Brief Report: Association Between Pregnancy Outcomes and Death From Cardiovascular Causes in Parous Women With Systemic Lupus Erythematosus: A Study Using Swedish Population Registries.
abstract: OBJECTIVE
  To determine if maternal placental syndromes (MPS) are associated with an increased risk of death from cardiovascular causes in women with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Between 1973 and 2011, women with SLE and a history of pregnancy were identified using linked Swedish population registries. The outcome was death from primarily cardiovascular causes, defined as death from acute coronary syndrome or coronary artery disease, stroke, or peripheral vascular disease. The exposure was MPS, defined as any hypertensive disorders in pregnancy, stillbirth, placental abruption, or delivery of a small-for-gestational-age infant. The association of preterm delivery (delivery at <34 weeks of gestation) with death from cardiovascular causes was also explored. Risk of death from cardiovascular causes was determined using logistic regression, adjusting for the year of first delivery, duration of SLE, number of inpatient admissions, and cardiovascular risk factors.
  
  
  RESULTS
  A total of 3,977 women with SLE had 7,410 pregnancies during the study interval. Death from primarily cardiovascular causes occurred in 44 of the 325 women who died (13.5%). The median age at death from cardiovascular causes was 54 years (interquartile range 48-58 years), and these women were more likely to have had hypertension and renal disease. MPS was associated with an increased risk of death from primarily cardiovascular causes (adjusted odds ratio [OR] 2.19 [95% confidence interval (95% CI) 1.14-4.22]), specifically, a history of placental abruption (adjusted OR 5.78 [95% CI 1.61-20.72]). Delivery at <34 weeks of gestation, particularly when combined with MPS, was also associated with an increased risk of death from primarily cardiovascular causes (adjusted OR 2.49 [95% CI 1.06-5.85]).
  
  
  CONCLUSIONS
  MPS in pregnancy is associated with a higher risk of death from primarily cardiovascular causes in women with SLE.
authors.affiliation: Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK, and University of Auckland and National Women's Health, Auckland, New Zealand (current address: John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK, and Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK).
authors.forename: May Ching
authors.initials: MC
authors.lastname: Soh
authors.affiliation: Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelson-Piercy
authors.affiliation: Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK.
authors.forename: Fadia
authors.initials: F
authors.lastname: Dib
authors.affiliation: Karolinska Institutet, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Westgren
authors.affiliation: University of Auckland and National Women's Health, Auckland, New Zealand.
authors.forename: Lesley
authors.initials: L
authors.lastname: McCowan
authors.affiliation: Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK.
authors.forename: Dharmintra
authors.initials: D
authors.lastname: Pasupathy
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology*; D054058:Acute Coronary Syndrome / Q000401:mortality; D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008180:Lupus Erythematosus, Systemic; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000401:mortality; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology*; D020521:Stroke / Q000401:mortality; D013548:Sweden / Q000453:epidemiology