The spectrum of commonly used medications among pregnant women with SLE may not be apparent to their health-care providers.
A more holistic approach to studying medication use among pregnant women with SLE is needed to gain a better understanding of the medication counselling needs of women with SLE who are pregnant or are planning pregnancy.
The aim was to characterize SLE medication trends before, during and after pregnancy and to compare other commonly used medications during SLE pregnancies with non-SLE pregnancies. Women with pregnancies ending in live birth or stillbirth were identified from the Swedish Medical Birth Register (2006–12).
National registers were used to identify women with prevalent SLE during pregnancy and a sample without SLE and to identify prescription medications dispensed from 3 months pre-pregnancy until 6 months postpartum.
Previous reports tended to focus on medications used to treat SLE, including HCQ, AZA and CSs, and few addressed heparin or other medications [6, 8, 11, 13, 15].
There is limited information regarding the timing and trajectory of medication use before, during and, especially, after SLE pregnancies [7, 10, 11, 14, 16].
The first SLE diagnosis for women included in this study occurred in 1977.
Women were classified as having prevalent SLE during each pregnancy if they had the following: (i) at least two discharges from either inpatient or outpatient records with diagnosis codes indicative of SLE [International Classification of Diseases (ICD), Eighth, Ninth or Tenth Revision, ICD-8 734.1, ICD-9 710.0 or ICD-10 M32], excluding drug-induced lupus, and including at least one SLE diagnosis from a department or specialist that typically diagnoses, treats or manages SLE (rheumatology, dermatology, nephrology, internal medicine and paediatrics) and at least one SLE diagnosis before the beginning of pregnancy; or (ii) at least one SLE discharge diagnosis from a department or specialist as described above and at least one self-reported diagnosis of SLE in the MBR for the current pregnancy.
Nearly all deliveries in Sweden (98%) are captured by the Medical Birth Register (MBR), which contains standardized information on maternal health during pregnancy, delivery and neonatal outcomes [5, 17].
Pregnancies with a delivery date between 5 August 2006 and 31 December 2012 were included in this study.