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

Creators: Dernoncourt, Amandine; Guettrot-Imbert, Gaëlle; Sentilhes, Loïc; Besse, Marie Charlotte; 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

Others:: CHU Amiens-Picardie; Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV (PERITOX) ; Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie; Université Paris Cité (UPCité); Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux); CHU Trousseau [Tours] ; Centre Hospitalier Régional Universitaire de Tours (CHRU Tours); Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Université Côte d'Azur - Faculté de Médecine (UCA Faculté Médecine) ; Université Côte d'Azur (UniCA); Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle (ImmunoConcept) ; Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); CHU Nice [Cimiez] ; Hôpital Cimiez [Nice] (CHU); Hôpital Pellegrin ; Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux)-Groupe hospitalier Pellegrin; Centre de référence des maladies auto-immunes systémiques rares du Nord et Nord Ouest [CHRU Lille] ; Hôpital Claude Huriez [Lille] ; Centre Hospitalier Régional Universitaire [CHU Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [CHU Lille] (CHRU Lille); Hôpital Michallon; Research support service: Methodological support to neuroimaging projects (CRNL-SC_SOUTIEN_IMAGERIE) ; Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Hôpital Robert Debré ; Hôpital Robert Debré ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital universitaire Robert Debré [Reims] (CHU Reims); Groupe Hospitalier Diaconesses Croix Saint-Simon; Service Médecine interne [CHU Toulouse] ; Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse) ; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers [La Milétrie]); CHU Clermont-Ferrand; CHU Henri Mondor [Créteil]; Maternité Port-Royal [CHU Cochin] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Description

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

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

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