Safety of Fertility Treatments in Women With Systemic Lupus Erythematosus: Data From a Prospective Population‐Based Study

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 132; no. 5; pp. 614 - 624
• Main Authors: Dernoncourt, Amandine, Guettrot‐Imbert, Gaëlle, Sentilhes, Loïc, Molto, Anna, Queyrel‐Moranne, Viviane, Besnerais, Maelle Le, Lazaro, Estibaliz, Tieulié, Nathalie, Richez, Christophe, Hachulla, Eric, Sarrot‐Reynauld, Françoise, Leroux, Gaëlle, Orquevaux, Pauline, London, Jonathan, Sailler, Laurent, Souchaud‐Debouverie, Odile, Smets, Perrine, Godeau, Bertrand, Pannier, Emmanuelle, Murarasu, Anne, Berezne, Alice, Goulenok, Tiphaine, Morel, Nathalie, Mouthon, Luc, Duhaut, Pierre, Guern, Véronique Le, Costedoat‐Chalumeau, Nathalie, Alexandra, Audemard‐Verger, Antoine, Baudet, Rakiba, Belkhir, Ygal, Benhamou, Sabine, Berthier, Holy, Bezanahary, Boris, Bienvenu, Julien, Campagne, Jérémy, Chatelais, Emmanuel, Chatelus, Elodie, Chauvet, Fleur, Cohen, Céline, Comparon, Marion, Couderc, Eric, Daugas, Mathilde, Menthon, Claire, Moreuil, Odile, Debouverie, Estelle, Delattre, Azeddine, Dellal, Alban, Deroux, Marine, Driessen, Isabelle, Durieu, Florence, Eboue, Olivier, Fain, Bruno, Fautrel, Nicole, Ferreira, Tiphaine, Goulenok, Philippe, Goupille, Claire, Grange, Constance, Guillaud‐Danis, Sabrina, Hamroun, Aurélie, Hummel, Laurence, Josselin‐Mahr, Noémie, Jourde‐Chiche, Vincent, Langlois, Céline, Lartigau Roussin, Christian, Lavigne, Nicolas, Limal, Matthieu, Mahevas, Hélène, Maillard, Hubert, Marotte, Nicolas, Martin Silva, Agathe, Masseau, François, Maurier, Arsène, Mekinian, Martin, Michaud, Olivier, Moranne, Chafika, Morati‐Hafsaoui, Nathalie, Morel, Guillaume, Moulis, Luc, Mouthon, Barbara, Nicolas, Rodérau, Outh, Elisabeth, Pasquier, Laurent, Perard, Hélène, Petit‐Bauer, Evangeline, Pillebout, Vincent, Poindron, Xavier, Puechal, Gregory, Pugnet, Viviane, Queyrel‐Moranne, Loic, Raffray, Alexis, Regent, Nicolas, Schleinitz, Raphaele, Seror, Aude, Servais, Vincent, Sobanski, Martin, Soubrier, Thierry, Thomas, Nathalie, Tieulié, Geoffrey, Urbanski, Emmanuelle, Weber
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2025; Wiley
• Subjects: Adult; assisted; Birth; Childrens health; Comparative analysis; Confounding (Statistics); Female; Fertility; France; France - epidemiology; Gynecology and obstetrics; high‐risk; Human health and pathology; Humans; in vitro fertilisation; Infertility, Female; Infertility, Female - etiology; Infertility, Female - therapy; Life Sciences; Live Birth; Live Birth - epidemiology; Lupus; Lupus Erythematosus, Systemic; Lupus Erythematosus, Systemic - complications; Neonates; Population studies; Pregnancy; Pregnancy Complications; Pregnancy Complications - epidemiology; Pregnancy Outcome; Pregnancy Outcome - epidemiology; Prospective Studies; reproductive techniques; Reproductive Techniques, Assisted; Reproductive Techniques, Assisted - adverse effects; Reproductive Techniques, Assisted - statistics & numerical data; Santé publique et épidémiologie; Systemic lupus erythematosus; Womens health; France; assisted; systemic lupus erythematosus; in vitro fertilisation; high‐risk; pregnancy; pregnancy outcome; reproductive techniques
• ISSN: 1470-0328; 1471-0528; 1471-0528
• DOI: 10.1111/1471-0528.18050

ABSTRACT Objective To assess safety of fertility treatments in women with systemic lupus erythematosus (SLE). Design Data from the multicentre French observational GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) study (2014‐ongoing). Setting Seventy‐six centres in France. Population All pregnancies in women with SLE enrolled in the GR2 study, conceived before 1 August 2022, with available end‐of‐pregnancy data and known conception type, were included; that is, 577 spontaneous and 53 assisted pregnancies. Methods A comparative analysis of spontaneous and assisted pregnancies was conducted. Logistic regression was used to determine if fertility treatments were independently associated with live birth prognosis, adjusting for confounders (e.g., maternal age). Kaplan–Meier analysis compared cumulative incidences of disease flares and adverse pregnancy outcomes (APOs), with confounding factors adjusted using a Cox regression model. Main Outcome Measures Live birth, disease flares, and APOs. Results The mean age was older (35.8 vs. 32.3 years, p < 1 × 10−4), and twins were more frequent in assisted pregnancies (5/50, 10.0% vs. 20/554, 3.6%; p = 0.047). Lupus disease was clinically inactive at baseline in 51 (96.2%) assisted pregnancies (vs. n = 511, 89.6%; p = 0.15), with 35 of 45 (77.8%) having no chronic damage (vs. 448/513, 87.3%; p = 0.07). The live birth rate was similar between assisted and spontaneous pregnancies (n = 46, 86.8% vs. n = 505, 87.5%; p = 0.83), with no statistical difference in the incidence of lupus flares and APOs. These results remained consistent after adjusting for confounding factors. Conclusions Fertility treatments in women with mostly well‐controlled SLE did not appear to increase risks of maternal and neonatal complications, supporting current recommendations. Trial Registration ClinicalTrials.gov identifier: NCT02450396