In:
Arthritis Care & Research, Wiley, Vol. 70, No. 2 ( 2018-02), p. 230-235
Abstract:
We examined rates of adverse pregnancy outcomes ( APO ) by race/ethnicity among women with systemic lupus erythematosus ( SLE ), with and without antiphospholipid antibodies ( aPL ), and whether socioeconomic status ( SES ) accounted for differences. Methods Data were from the PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study, a multicenter study that enrolled 346 patients with SLE and 62 patients with SLE and aPL (50% white, 20% African American, 17% Hispanic, 12% Asian/Pacific Islander). Measures of SES were educational attainment, median community income, and community education. Logistic regression analyses were conducted to determine odds of APO for each racial/ethnic group, controlling first for age and clinical variables, and then for SES . Results The frequency of APO in white women with SLE , with and without aPL , was 29% and 11%, respectively. For African American and Hispanic women it was approximately 2‐fold greater. In African American women with SLE alone, adjustment for clinical variables attenuated the odds ratio ( OR ) from 2.7 (95% confidence interval [95% CI ] 1.3–5.5) to 2.3 (95% CI 1.1–5.1), and after additional adjustment for SES , there were no longer significant differences in APO compared to whites. In contrast, in SLE patients with aPL , whites, African Americans, and Hispanics had markedly higher risks of APO compared to white SLE patients without aPL ( OR 3.5 [95% CI 1.4–7.7], OR 12.4 [95% CI 1.9–79.8], and OR 10.4 [95% CI 2.5–42.4], respectively), which were not accounted for by clinical or SES covariates. Conclusion This finding suggests that for African American women with SLE without aPL , SES factors are key contributors to disparities in APO , despite monthly care from experts, whereas other factors contribute to disparities in SLE with aPL .
Type of Medium:
Online Resource
ISSN:
2151-464X
,
2151-4658
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2016713-1
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