Veterans With Lupus and RA Have Higher Pregnancy Risks

A new study in ACR Open Rheumatology reveals that female veterans with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) face substantially higher risks of pregnancy loss and severe maternal morbidity compared to other veterans.

Analyzing Department of Veterans Affairs (VA) health records from 2009–2019, researchers identified 29,713 pregnancies, including 113 in women with SLE and 92 with RA.

Among these, 36% of SLE pregnancies and 30% of RA pregnancies ended in nonlive births (stillbirth, ectopic pregnancy, or miscarriage), compared to 25% in other veterans.

Rates of life-threatening maternal complications, such as renal failure, sepsis, and need for transfusion, were also elevated.

9.7% of veterans with SLE and 4.3% of those with RA, versus 3.2% in the comparison group, had life-threatening maternal complications.

Comorbid conditions were strikingly common: nearly one in five veterans with SLE had end-stage kidney disease, and over one-third had pulmonary hypertension, both major contributors to poor pregnancy outcomes. Half of the women with lupus were Black, echoing known racial disparities in maternal health.

The authors conclude that VA maternity care models must better integrate rheumatology expertise to support those with autoimmune conditions. They also stress the need for tailored strategies that address overlapping medical, mental health, and social risks.

Citation

Quinn, D. A., et al. (2025). Severe Maternal Morbidity During and After Pregnancy Among Veterans With Systemic Lupus Erythematosus or Rheumatoid Arthritis. ACR open rheumatology, 7(9), e70100. https://doi.org/10.1002/acr2.70100