Preterm birth is one of the most frequent complications of pregnancy in women with systemic lupus erythematosus. The high indicated preterm birth proportion due to hypertensive disorders of pregnancy and/or fetal growth restriction is well known, and preventive measures and screening for early detection are performed. The risk of spontaneous preterm birth is less well recognized. This study aimed to determine the proportions of spontaneous and indicated preterm birth in pregnancies of women with systemic lupus erythematosus. A systematic literature search using Pubmed, Embase, Web of Science, and Google Scholar was performed in June 2021. Studies in pregnant women with systemic lupus erythematosus reporting spontaneous and indicated preterm birth rates were selected. Original research articles published from 1995 to June 2021 were included. Quality and risk of bias of the included studies were assessed using the Newcastle–Ottawa quality assessment scale. To estimate the pooled event rates and 95% confidence intervals, meta-analysis of single proportions with a random-effects model was performed. We included 21 articles, containing data of 8157 pregnancies in women with systemic lupus erythematosus. On average, 31% (95% prediction interval, 0.14–0.50) of the pregnancies resulted in preterm birth, including 14% (95% prediction interval, 0.04–0.27) spontaneous and 16% (95% prediction interval, 0.03–0.35) indicated preterm birth. In pregnant women with systemic lupus erythematosus, spontaneous and indicated preterm birth proportions are high. This information should be applied in (prepregnancy) counseling and management in pregnancy. The knowledge obtained by this meta-analysis paves the way for further research of associated risk factors and development of interventions to reduce spontaneous preterm birth in systemic lupus erythematosus pregnancies.

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系统性红斑狼疮与自发性早产频率增加相关：系统评价和荟萃分析

早产是患有系统性红斑狼疮的女性最常见的妊娠并发症之一。众所周知，由于妊娠期高血压疾病和/或胎儿生长受限而导致的早产比例很高，因此采取了预防措施和早期发现筛查。自发性早产的风险尚未得到充分认识。本研究旨在确定患有系统性红斑狼疮的女性妊娠期间自发性早产和指示性早产的比例。 2021 年 6 月，使用 Pubmed、Embase、Web of Science 和 Google Scholar 进行了系统文献检索。选择了对患有系统性红斑狼疮孕妇报告自发早产率和指示早产率的研究。包括1995年至2021年6月发表的原创研究文章。使用纽卡斯尔-渥太华质量评估量表评估纳入研究的质量和偏倚风险。为了估计汇总事件率和 95% 置信区间，使用随机效应模型对单一比例进行了荟萃分析。我们纳入了 21 篇文章，其中包含 8157 名患有系统性红斑狼疮的女性怀孕的数据。平均而言，31%（95%预测区间，0.14–0.50）的妊娠导致早产，其中14%（95%预测区间，0.04–0.27）自然早产，16%（95%预测区间，0.03–0.35）提示早产。在患有系统性红斑狼疮的孕妇中，自发性早产和指示性早产的比例很高。该信息应应用于怀孕期间的（孕前）咨询和管理。通过这项荟萃分析获得的知识为进一步研究相关危险因素和制定干预措施以减少系统性红斑狼疮妊娠中的自发性早产铺平了道路。