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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Medical/Surgical/Diseases/Complications

Poster Session 3

(943) Association of Autoimmune Disease with Hypertensive Disorders of Pregnancy

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
Certain autoimmune diseases, like systemic lupus erythematosus, are linked with hypertensive disorders of pregnancy (HD), prompting the recommendation for prophylactic low-dose aspirin. This study examined the association between other autoimmune disorders and HDP.  

Study Design:
This was a retrospective cohort study of all pregnant patients with live births at ≥23 weeks’ gestation from 2019-2024 in a large health system in New York. The primary exposure was autoimmune disease, limited to conditions eligible for TNF-alpha inhibitor therapy. These conditions are characterized by chronic inflammation and immune dysregulation, which could theoretically contribute to placental dysfunction and HDP. The primary outcome was HDP, and secondary outcome was preeclampsia with severe features. A subgroup analysis was done for pregnancies complicated by inflammatory bowel disease (IBD). Multivariable logistic regression was used to assess the association between the exposure and the outcomes, adjusting for body mass index class, advanced maternal age, multiparity, insurance status, English-speaking, and race/ethnicity. Analyses were performed using R 4.3.1.    

Results:
Of 139,671 pregnancies included, 520 (0.4%) were complicated by autoimmune disease and 319 (0.2%) had IBD specifically. Of those with autoimmune disease, 77 (14.8%) were complicated by an HDP diagnosis, compared to 20,605 (14.8%) without autoimmune diseases. In adjusted and unadjusted analyses (Table 1), there was no increased risk for HDP (aOR 1.00, 95% CI 0.78–1.27) or preeclampsia with severe features. Of those with IBD, 40 (12.5%) were complicated by an HDP diagnosis. In the subgroup analysis (Table 2), those with IBD also had no increased risk of HDP (aOR 0.82, 95% CI 0.58–1.13) or severe preeclampsia. 

Conclusion:
While some autoimmune diseases have known strong associations with preeclampsia, this study suggests that autoimmune diseases overall, including IBD, are not independently associated with HDP. Low dose aspirin use in these patients can be recommended based on other comorbidities in accordance with ACOG guidelines.