Rheumatic diseases predominantly affect women with over 70% of prevalent cases in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) [1]. Moreover, these diseases commonly affect women of child-bearing age. Women with rheumatic diseases have been found to have a higher frequency of adverse pregnancy outcomes (APOs) [2,3]. In a study by Sugawara et al., pregnancies with rheumatic diseases were more likely to encounter preterm delivery and emergency cesarean section compared to the general obstetric population [4].

Racial disparity is a contributor to the prevalence of APOs in both women with rheumatic diseases and the general population. The 2015 National Vital Statistics Report demonstrated that Hispanic births had a higher incidence rate of preterm birth and term low birth rate compared to non-Hispanic White births. Additionally, non-Hispanic Black births were 1.5 times more likely to encounter preterm birth and more than twice as likely to have term low birth weight [5]. In a study that utilized the Nationwide Inpatient Sample, Black and Hispanic women with SLE had higher rates of cesarean section delivery, fetal growth restriction, and preterm labor, with preterm labor occurring in only 14.3% of White women with SLE compared to 24.7% and 20.6% in Black and Hispanic patients, respectively [6]. Thus, race and rheumatic diseases are independently associated with adverse birth outcomes. Yet, the overall association of race with adverse birth outcomes in women with rheumatic diseases is unknown. Prior studies have investigated aspects of this issue; however, limitations of rheumatic disease type and race ascertainment prevent single studies from synthesizing a complete analysis. The aim of this study was to conduct a systematic literature review of observational studies of women with rheumatic diseases focusing on the association between race and APOs.