Maternal and neonatal outcomes in SLE: comparison of 430 pregnancies from the French GR2 study with 1720 pregnancies from French perinatal surveys

@article{dernoncourt2026maternal,
  title = {{Maternal and neonatal outcomes in SLE: comparison of 430 pregnancies from the French GR2 study with 1720 pregnancies from French perinatal surveys}},
  author = {Amandine Dernoncourt and Jean Schmidt and Gaëlle Guettrot-Imbert and Grégoire Martin De Frémont and Anne Murarasu and Marie Viaud and Camille Le Ray and Estibaliz Lazaro and Tiphaine Goulenok and Alban Deroux and Alice Berezne and Loic Raffray and Chafika Morati-Hafsaoui and Christophe Richez and Eric Hachulla and Julien Campagne and Nicolas Schleinitz and Olivier Moranne and Vincent Langlois and Odile Debouverie and Francoise Sarrot-Reynauld and Viviane Queyrel and Pauline Orquevaux and Laurent Sailler and Maddalena Larosa and Anna Molto and Véronique Le Guern and Loïc Sentilhes and Nathalie Costedoat-Chalumeau and Abisror Noemie},
  journal = {Lupus Science \& Medicine},
  year = {2026},
  month = nov,
  doi = {10.1136/lupus-2026-002300},
  url = {https://doi.org/10.1136/lupus-2026-002300},
  note = {CC BY-NC 4.0},
}

TY  - JOUR
TI  - Maternal and neonatal outcomes in SLE: comparison of 430 pregnancies from the French GR2 study with 1720 pregnancies from French perinatal surveys
AU  - Amandine Dernoncourt
AU  - Jean Schmidt
AU  - Gaëlle Guettrot-Imbert
AU  - Grégoire Martin De Frémont
AU  - Anne Murarasu
AU  - Marie Viaud
AU  - Camille Le Ray
AU  - Estibaliz Lazaro
AU  - Tiphaine Goulenok
AU  - Alban Deroux
AU  - Alice Berezne
AU  - Loic Raffray
AU  - Chafika Morati-Hafsaoui
AU  - Christophe Richez
AU  - Eric Hachulla
AU  - Julien Campagne
AU  - Nicolas Schleinitz
AU  - Olivier Moranne
AU  - Vincent Langlois
AU  - Odile Debouverie
AU  - Francoise Sarrot-Reynauld
AU  - Viviane Queyrel
AU  - Pauline Orquevaux
AU  - Laurent Sailler
AU  - Maddalena Larosa
AU  - Anna Molto
AU  - Véronique Le Guern
AU  - Loïc Sentilhes
AU  - Nathalie Costedoat-Chalumeau
AU  - Abisror Noemie
PY  - 2026
DA  - 2026/11/03
JO  - Lupus Science & Medicine
DO  - 10.1136/lupus-2026-002300
UR  - https://doi.org/10.1136/lupus-2026-002300
AB  - Background: Pregnancy in women with SLE is considered high risk, particularly in the presence of active disease, organ damage or lupus anticoagulant (LA). Improvements in SLE and obstetric management may have enhanced outcomes.  Methods: We compared pregnancies from the prospective GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) cohort with those from the French general population using perinatal survey (Enquêtes Nationales Périnatales (ENP)) data. Eligible pregnancies resulted in a birth ≥22 weeks of gestation (WG) or ≥500 g, in accordance with the ENP inclusion criteria. Each GR2 pregnancy was matched with four ENP pregnancies based on maternal age, parity, number of fetuses and region. Live birth rates were evaluated after excluding minors, anonymous births and refusals. Adverse pregnancy outcomes (APOs) were assessed among live births with complete medical records and were defined as placental insufficiency-related preterm birth, severe small-for-gestational-age infant (birth weight <3rd percentile) or neonatal death.  Results: We matched 430 GR2 pregnancies to 1720 ENP pregnancies. At inclusion, 336/397 (84.6%) women had no clinical lupus activity, 327/385 (84.9%) had no organ damage, 68/428 (15.9%) were LA-positive and 417/430 (97.0%) received hydroxychloroquine. Live births occurred in 423/430 (98.4%) GR2 pregnancies versus 1667/1720 (97.0%) ENP pregnancies (OR=1.49 (0.64 to 3.45); p=0.14). APOs occurred in 75/406 (18.5%) SLE pregnancies versus 134/1629 (8.2%) ENP pregnancies (OR=2.53 (1.86 to 3.44); p<0.001). APOs remained higher in GR2 pregnancies without disease activity, organ damage or LA positivity (30/209; 14.4%) than in ENP pregnancies (p<0.01). Univariate analysis identified SLE, nulliparity, smoking, chronic hypertension, twin pregnancy and fertility treatment as APO-associated factors. In multivariate analysis, SLE remained independently associated with APOs (aOR=2.91 (2.06 to 4.09); p<0.001).  Conclusion: Among pregnancies progressing beyond 22 WG (or birth weight ≥500 g), live birth rates were comparable to those in the general population, but APOs were more than two times as frequent in women with SLE.  Trial registration number: NCT02450396.
SN  - 2053-8790
ER  -