Healthcare aspects, course and outcome of pregnancies of women with systemic lupus erythematosus

• Applicant: Dr. Yvette Meißner
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 533620604

Pregnancies in women with systemic lupus erythematosus (SLE) are associated with a higher risk of maternal and fetal complications. However, data on the reality of care in Germany and on complication rates have not yet been published. The research project focuses on two objectives: (I) Investigation of patterns of healthcare resource utilisation of pregnant women with SLE with regard to treatment with anti-rheumatic drugs and the contact to specialist physicians and (II) Investigation of the frequency of pregnancy complications in women with SLE, exemplified by pre-eclampsia and premature birth. In the project, cohort data and claims data will be evaluated in parallel and the results will be compared with each other. The data source for the cohort data is the multicentre prospective longitudinal pregnancy register Rhekiss: Rheumatism – Child Wish and Pregnancy. The claims data are based on routine data from the BARMER health insurance fund. Since 09/2015, women with different inflammatory rheumatic diseases have been included in the Rhekiss register by their treating rheumatologist, either already at the time of family planning or in early pregnancy, and data are documented at regular time points. In both data sources, women with SLE who are at least 18 years old and for whom a singleton pregnancy has been reported will be identified. The type of anti-rheumatic therapy prescribed in the year before conception and during pregnancy will be determined and possible changes described. The quarterly utilisation of rheumatological and other specialist consultations will be examined additionally in the claims data. The frequency of occurrence of pre-eclampsia and premature birth will be analysed, and the temporal trend of complication rates over an observation period of eight (cohort data) and 17 years (claims data) will be presented. Descriptive methods of health services research epidemiology will be applied to both data sources. The evaluation of two different data sources offers the opportunity to describe healthcare utilisation patterns of pregnant women with SLE in Germany as well as complication rates for the first time and to map temporal trends. In addition, pregnancy- and disease-specific characteristics of those affected can be compared from both data sources. The comprehensive knowledge of the healthcare situation of pregnant women with SLE will be the basis for developing patient- and physician-oriented information and education material. In addition, possible relevant gaps in healthcare can be identified.

• DFG Programme: Research Grants