{"doi":"10.1002/art.70018","title":"Nationwide Temporal Trends in Adverse Pregnancy Outcomes and Treatments in Systemic Lupus Erythematosus Pregnancy Over Two Decades in Sweden","abstract":"OBJECTIVE: This nationwide descriptive study examined temporal trends in adverse pregnancy outcomes (APOs) and treatments in systemic lupus erythematosus (SLE) pregnancies in Sweden over 2003 to 2022. METHODS: Using nationwide Swedish registers, we identified 1,417 pregnancies of women with prevalent SLE and delivery dates in 2003 to 2022 and matched them to 14,133 non-SLE pregnancies from the general population on maternal age, delivery year, and parity. We assessed proportions of preeclampsia, preterm delivery, and small for gestational age (SGA) birth over time. Antimalarial, glucocorticoid, and low-dose aspirin use were examined during 2007 to 2022. Binomial generalized linear models with an identity link quantified mean annual absolute change (expressed in percentage points [pp]) in APO and treatment proportions. RESULTS: Overall, SLE pregnancies had 9.1% preeclampsia, 14.7% preterm delivery, and 6.9% SGA births (2003-2022). These outcomes remained stable in the general population but decreased in SLE pregnancies (preeclampsia from 14.1% in 2003-2004 to 9.6% in 2021-2022, -0.11 pp/y; preterm delivery from 25.9% to 11.2%, -0.63 pp/y; and SGA birth from 10.6% to 7.0%, -0.22 pp/y). Declines were more pronounced in nulliparous versus parous SLE pregnancies. APOs modestly decreased over time in SLE pregnancies with antiphospholipid syndrome. Antimalarial use during pregnancy increased from 23.9% in 2007-2008 to 76.5% in 2021-2022 (+3.3 pp/y). Low-dose aspirin use during pregnancy rose from 39.8% to 85.6% (+3.7 pp/y), whereas glucocorticoid use slightly decreased from 43.2% to 40.1% (-0.7 pp/y). CONCLUSION: APOs in SLE pregnancies have decreased over the past two decades, potentially reflecting improved treatment strategies, particularly increased use of antimalarials and low-dose aspirin.","journal":"Arthritis & Rheumatology","year":2025,"id":522462,"datarank":0.26876392038420827,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.0,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.0,"corpus_percentile":41.63378974239963,"corpus_rank":7489,"citation_count":5,"citer_count":4,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.7206,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1060391,"name":"Anna Sandström","orcid":"0000-0003-2879-4271","position":1,"is_corresponding":false},{"id":1220417,"name":"Annica Dominicus","orcid":"0009-0004-1501-7929","position":2,"is_corresponding":false},{"id":392721,"name":"Elisabet Svenungsson","orcid":"0000-0003-3396-3244","position":3,"is_corresponding":false},{"id":1220419,"name":"Karin Hellgren","orcid":"0000-0001-7149-0973","position":4,"is_corresponding":false},{"id":249439,"name":"Julia F. Simard","orcid":"0000-0001-5735-9856","position":5,"is_corresponding":false},{"id":732704,"name":"Elizabeth V. Arkema","orcid":"0000-0002-3677-9736","position":6,"is_corresponding":false},{"id":1394541,"name":"Ngoc Viet Nguyen","orcid":null,"position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:49:54.058858Z","pmid":"41429597","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}