Lupus women with delivery with higher risk of heart failure compared with those without pregnancy but neutral in major adverse cardiovascular events. A population-based matched cohort study

Objective Limited data exist regarding the incidence rate and relative risks of major adverse cardiovascular events in women with lupus who have successfully delivered compared to those who have not been pregnant. Methods A retrospective, population-based matched cohort study was performed on women with lupus from 2000 to 2006. In total, 149 women with lupus and a successful delivery were enrolled as the study cohort, and 446 women with lupus with no pregnancy, frequency-matched for age, duration of systemic lupus erythematosus, hypertension and diabetes as the comparison cohort. Poisson regression modeling was used to determine the relative risk of a successful delivery on the risk of major adverse cardiovascular events among the women with lupus. Results Successful delivery for women with lupus had a neutral effect on major adverse cardiovascular events. The incidence rate of any major adverse cardiovascular event was 1,139 per 100,000 person-years, consisting mainly of heart failure, stroke, and all-cause mortality, with incidence rates of 652, 481 and 481 per 100,000 person-years, respectively. The women with lupus and a successful delivery had a higher incidence rate of heart failure (RR=5.4, 95% CI=1.4-21.7, p<0.017). Conclusion Major adverse cardiovascular events and mortality were rare events in the women with lupus of reproductive age. Successful delivery had a neutral effect on major adverse cardiovascular events in the women with lupus, although they had a higher incidence of heart failure.