Reproductive health in Mexican women with systemic lupus erythematosus: pregnancy outcomes, menstrual irregularities and early menopause
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Objective
To characterize pregnancy outcomes and menstrual irregularities in Mexican women with systemic lupus erythematosus (SLE) and identify clinical factors associated.
Methods
We conducted a cross-sectional study of women with SLE enrolled in the Mexican Lupus Registry (LupusRGMX) between May 2021 and September 2024. Clinical and reproductive data were collected using standardized questionnaires. Menopause was defined as the absence of menstruation for ≥12 consecutive months, and early menopause before age 40. Univariable and multivariable logistic regression analyses were used to identify factors associated with pregnancy complications and early menopause.
Results
A total of 210 women were included. Median age was 38 years (IQR 29–46) and median disease duration was 4 years (IQR 1–10). Among women with a history of pregnancy (47%), full-term delivery predominated (61%), while pregnancy loss occurred in 26% and preterm delivery in 13%. Pregnancy complications were reported in 9.6%, most commonly preeclampsia (6.7%). Younger maternal age was independently associated with pregnancy complications (OR 0.89, 95% CI 0.83–0.95) and adverse outcomes (OR 0.95, 95% CI 0.92–0.98). Higher disease activity was associated with complications in univariable analysis. Most pregnancies (68.3%) occurred before diagnosis. Early menopause was observed in 6.2% and was independently associated with longer disease duration.
Conclusion
Younger maternal age was independently associated with adverse pregnancy outcomes in women enrolled in the LupusRGMX. Most pregnancies occurred prior to SLE diagnosis. Early menopause was associated with longer disease duration, suggesting the impact of cumulative disease burden on ovarian function.
