Preeclampsia in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

Objectives The impact of systemic lupus erythematosus (SLE) on preeclampsia is still obscure. This study was performed to systematically assess the association between preeclampsia and SLE. Method According to the PRISMA statement, designed literature research was performed in PubMed, Web of Science, and Cochrane Library from inception to June 30, 2018. The pooled risk ratio (RR) of preeclampsia in pregnant SLE patients compared with health controls was synthesized by fixed effect model or random effects model depending on heterogeneity. Results Ten studies involving 6,389 SLE patients were included. Pregnant women with SLE have significantly increased risk of preeclampsia (RR = 2.99, 95% CI = 2.31 to 3.88; Z = 8.31, P < 0.001) compared with health controls. Subgroup analysis showed that the risk of preeclampsia was significant (Q = 7.64, P = 0.006) higher in prospective studies (RR = 6.94, 95% CI = 3.59 to 13.42) compared to retrospective studies (RR = 2.60, 95% CI = 2.08 to 3.25). Conclusions The present study demonstrated that pregnant SLE patients have a high risk of preeclampsia, suggesting a pivotal role of SLE in the pathogenesis of preeclampsia. For rheumatologists and SLE patients, it is important to maintain inactive disease activity and prevent complications as LN, and the control of traditional risk factors of preeclampsia is also pivotal. Further study focus on the prevention of preeclampsia in SLE is also urgent.