{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:28Z","timestamp":1792787308210,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":76,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002193","name":"Lupus Foundation of America","doi-asserted-by":"publisher","award":["Gary S Gilkeson Career Development Award"],"award-info":[{"award-number":["Gary S Gilkeson Career Development Award"]}],"id":[{"id":"10.13039\/100002193","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Building Interdisciplinary Research Careers in Women\u2019s Health","award":["Faculty Scholar Program"],"award-info":[{"award-number":["Faculty Scholar Program"]}]},{"name":"University of California San Diego (UCSD) Maternal and Pediatric Precision in Therapeutics Center of Excellence in Therapeutics","award":["Support Pool Funding"],"award-info":[{"award-number":["Support Pool Funding"]}],"id":[{"id":"https:\/\/ror.org\/0168r3w48","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,8,14]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to characterise differences in the occurrence of maternal cardiovascular events (CVEs) and adverse pregnancy outcomes (APOs) in each of four racial\/ethnic groups compared with non-Hispanic white women with SLE and to evaluate whether the relationship between CVEs and APOs differed across or within racial\/ethnic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a California population-based birth cohort (2005\u20132020), we identified pregnant individuals with SLE via International Classification of Diseases codes from maternal discharge records. Self-reported racial\/ethnic groups were categorised as Asian, Hispanic, non-Hispanic black, non-Hispanic white and other. Individuals with reported race or ethnicity as \u2018unknown\u2019 or \u2018not stated\u2019 were excluded from the study. Log-linear regression estimated adjusted relative risks (aRRs) of CVEs and APOs in each racial\/ethnic group compared with non-Hispanic white individuals, adjusting for a propensity score derived from maternal age, payer, education, comorbidities and SLE-related variables. We performed CVE-stratified analyses for racial\/ethnic differences in APOs and examined associations between CVEs and APOs within each racial\/ethnic group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8188 liveborn singletons from women with SLE, non-Hispanic black women had the highest prevalence of maternal CVEs (4.0% vs 1.6\u20132.0% in other groups), maternal APOs (24.6% vs 13.5\u201317.2%) and infant APOs (54.6% vs 34.6\u201349.4%). Relative to non-Hispanic white women, non-Hispanic black women had an aRR of 1.6 (95% CI 0.9 to 2.6) for maternal CVEs and 1.3 (95% CI 1.1 to 1.6) for maternal APOs, whereas infant APO risks were significantly higher across three of four racial\/ethnic groups compared with non-Hispanic white women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non-Hispanic black women exhibited the highest absolute burden for the adverse outcomes studied. Relative to non-Hispanic white individuals, elevated adjusted risks based on race\/ethnicity were most consistent for infant APOs, whereas elevated risks for maternal APOs and CVEs were found primarily among non-Hispanic black individuals. Social drivers of health need consideration while caring for pregnant individuals with SLE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001846","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:56:16Z","timestamp":1789480576000},"page":"e001846","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Racial differences in cardiovascular events and adverse pregnancy outcomes among pregnant individuals with SLE"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-7844","authenticated-orcid":false,"given":"Rashmi","family":"Dhital","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Rheumatology and Immunology, Vanderbilt Health, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J","family":"Baer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Environmental Science and Health, University of California San Diego, La Jolla, California, USA"},{"name":"The California Preterm Birth Initiative, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilli R","family":"Poudel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology and Immunology, Vanderbilt Health, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy M","family":"Frech","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology and Immunology, Vanderbilt Health, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Environmental Science and Health, University of California San Diego, La Jolla, California, USA"},{"name":"Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026091506553365000_13.2.e001846.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajogmf.2024.101319","article-title":"Maternal cardiovascular events in autoimmune rheumatic diseases and antiphospholipid syndrome pregnancies","volume":"6","author":"Dhital","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2026091506553365000_13.2.e001846.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2017.02.009"},{"key":"2026091506553365000_13.2.e001846.3","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ajog.2008.03.012","article-title":"A national study of the complications 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in Mothers and Infants (a Population-Based Research Resource): Retrospective Cohort Study","volume":"10","author":"Baer","year":"2024","journal-title":"JMIR Public Health Surveill"},{"key":"2026091506553365000_13.2.e001846.12","unstructured":"CDC . Identifying severe maternal morbidity (SMM). Maternal Infant Health; 2024. Available: https:\/\/www.cdc.gov\/maternal-infant-health\/php\/severe-maternal-morbidity\/icd.html [Accessed 7 Sep 2024]."},{"key":"2026091506553365000_13.2.e001846.13","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3285"},{"key":"2026091506553365000_13.2.e001846.14","doi-asserted-by":"crossref","first-page":"S694","DOI":"10.1016\/j.ajog.2022.11.1163","article-title":"Racial & ethnic disparities in prenatal care & pregnancy outcomes - an ongoing challenge","volume":"228","author":"Ayyash","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"2026091506553365000_13.2.e001846.15","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1007\/s10067-023-06606-8","article-title":"Racial\/ethnic disparities in the risk of preterm birth among women with systemic lupus erythematosus or rheumatoid arthritis","volume":"42","author":"Strouse","year":"2023","journal-title":"Clin Rheumatol"},{"key":"2026091506553365000_13.2.e001846.16","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.220279"},{"key":"2026091506553365000_13.2.e001846.17","doi-asserted-by":"crossref","DOI":"10.1016\/j.xagr.2023.100215","article-title":"Military healthcare system mitigates racial disparities for severe maternal morbidity from preeclampsia","volume":"3","author":"Lundeberg","year":"2023","journal-title":"AJOG Glob Rep"},{"key":"2026091506553365000_13.2.e001846.18","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwz105"},{"key":"2026091506553365000_13.2.e001846.19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1177\/09612033251406326","article-title":"Racial differences in medication beliefs and adherence barriers among patients with systemic lupus erythematosus","volume":"35","author":"Rangaswamy","year":"2026","journal-title":"Lupus"},{"key":"2026091506553365000_13.2.e001846.20","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17104"},{"key":"2026091506553365000_13.2.e001846.21","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.014775","article-title":"Maternal Race\/Ethnicity, Hypertension, and Risk for Stroke During Delivery Admission","volume":"9","author":"Miller","year":"2020","journal-title":"JAHA"},{"key":"2026091506553365000_13.2.e001846.22","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ajog.2022.09.025","article-title":"Perinatal outcomes in pregnancies complicated by maternal cardiomyopathy: a systematic review and meta-analysis","volume":"228","author":"Eggleton","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"2026091506553365000_13.2.e001846.23","doi-asserted-by":"crossref","first-page":"1489991","DOI":"10.3389\/fmed.2025.1489991","article-title":"Heart disease in pregnancy and adverse outcomes: an umbrella review","volume":"12","author":"Zhang","year":"2025","journal-title":"Front Med"},{"key":"2026091506553365000_13.2.e001846.24","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2021-000602","article-title":"Hydroxychloroquine PK and exposure-response in pregnancies with lupus: the importance of adherence for neonatal outcomes","volume":"9","author":"Balevic","year":"2022","journal-title":"Lupus Sci Med"},{"key":"2026091506553365000_13.2.e001846.25","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.semarthrit.2018.01.002","article-title":"Dynamic patterns and predictors of hydroxychloroquine nonadherence among Medicaid beneficiaries with systemic lupus erythematosus","volume":"48","author":"Feldman","year":"2018","journal-title":"Semin Arthritis Rheum"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2025-001846","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:56:20Z","timestamp":1789480580000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2025-001846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,9,15]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/lupus-2025-001846"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2025-001846","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}