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  1. Giannakopoulou O, Lin K, Meng X, Su MH, Kuo PH, Peterson RE, et al.
    JAMA Psychiatry, 2021 Nov 01;78(11):1258-1269.
    PMID: 34586374 DOI: 10.1001/jamapsychiatry.2021.2099
    IMPORTANCE: Most previous genome-wide association studies (GWAS) of depression have used data from individuals of European descent. This limits the understanding of the underlying biology of depression and raises questions about the transferability of findings between populations.

    OBJECTIVE: To investigate the genetics of depression among individuals of East Asian and European descent living in different geographic locations, and with different outcome definitions for depression.

    DESIGN, SETTING, AND PARTICIPANTS: Genome-wide association analyses followed by meta-analysis, which included data from 9 cohort and case-control data sets comprising individuals with depression and control individuals of East Asian descent. This study was conducted between January 2019 and May 2021.

    EXPOSURES: Associations of genetic variants with depression risk were assessed using generalized linear mixed models and logistic regression. The results were combined across studies using fixed-effects meta-analyses. These were subsequently also meta-analyzed with the largest published GWAS for depression among individuals of European descent. Additional meta-analyses were carried out separately by outcome definition (clinical depression vs symptom-based depression) and region (East Asian countries vs Western countries) for East Asian ancestry cohorts.

    MAIN OUTCOMES AND MEASURES: Depression status was defined based on health records and self-report questionnaires.

    RESULTS: There were a total of 194 548 study participants (approximate mean age, 51.3 years; 62.8% women). Participants included 15 771 individuals with depression and 178 777 control individuals of East Asian descent. Five novel associations were identified, including 1 in the meta-analysis for broad depression among those of East Asian descent: rs4656484 (β = -0.018, SE = 0.003, P = 4.43x10-8) at 1q24.1. Another locus at 7p21.2 was associated in a meta-analysis restricted to geographically East Asian studies (β = 0.028, SE = 0.005, P = 6.48x10-9 for rs10240457). The lead variants of these 2 novel loci were not associated with depression risk in European ancestry cohorts (β = -0.003, SE = 0.005, P = .53 for rs4656484 and β = -0.005, SE = 0.004, P = .28 for rs10240457). Only 11% of depression loci previously identified in individuals of European descent reached nominal significance levels in the individuals of East Asian descent. The transancestry genetic correlation between cohorts of East Asian and European descent for clinical depression was r = 0.413 (SE = 0.159). Clinical depression risk was negatively genetically correlated with body mass index in individuals of East Asian descent (r = -0.212, SE = 0.084), contrary to findings for individuals of European descent.

    CONCLUSIONS AND RELEVANCE: These results support caution against generalizing findings about depression risk factors across populations and highlight the need to increase the ancestral and geographic diversity of samples with consistent phenotyping.

    Matched MeSH terms: Far East/ethnology
  2. Thai AC, Mohan V, Khalid BA, Cockram CS, Pan CY, Zimmet P, et al.
    Diabetes Res Clin Pract, 2008 May;80(2):224-30.
    PMID: 18207602 DOI: 10.1016/j.diabres.2007.12.003
    In this paper, the islet autoimmunity status and relation to clinical characteristics, beta cell function and cardio-metabolic risk factors in young-onset Asian diabetic patients are evaluated at baseline. The study population consisted of 912 patients (from China, India, Malaysia and Singapore) with age 12-40 years and diabetes duration <12 months. Autoantibodies to glutamic acid decarboxylase (GADA) and tyrosine phosphatase (IA-2A), beta cell function and cardio-metabolic risk parameters were assessed. Among our young patient cohort, 105 (11.5%) patients were GADA and/or IA-2A positives (Ab +ve). Ab +ve patients were younger, leaner, had more severe hyperglycaemia and lower beta cell function. The frequency of metabolic syndrome was significantly lower in Ab +ve patients (27%) compared to Ab -ve patients (54%). However, a substantial proportion of patients in both groups of patients had atherogenic dyslipidaemia, hypertension and albuminuria (micro or macro). In our study cohort, only one in 10 Asian youth with new-onset diabetes had evidence of islet autoimmunity. At least 60% of Ab +ve and 50% of Ab -ve patients demonstrated classical features of type 1 and type 2 diabetes respectively. Regardless of autoimmunity status, the cardio-metabolic risk factors, in particular atherogenic dyslipidaemia, hypertension and albuminuria were common in our patients with young-onset diabetes.
    Matched MeSH terms: Asian Continental Ancestry Group/ethnology
  3. Pan CY, So WY, Khalid BA, Mohan V, Thai AC, Zimmet P, et al.
    Diabet Med, 2004 Sep;21(9):1007-13.
    PMID: 15317606 DOI: 10.1111/j.1464-5491.2004.01287.x
    AIM: To describe the clinical, biochemical and immunological characteristics of young-onset diabetes in Asia.
    METHODS: Clinical, biochemical and immunological variables were assessed in 919 newly diagnosed (duration less than 12 months) young onset Asian diabetic patients aged between 12 and 40 years. The subjects constituted 57% Chinese, 29% Indians and 14% Malays, recruited from diabetes centres in China, Hong Kong, India, Malaysia and Singapore.
    RESULTS: The mean age (+/- sd) was 31.6 +/- 7.2 years, with the majority (66%) in the 31-40 years age group. Mean body mass index (BMI) (+/- sd) was 25.3 +/- 5.0 kg/m2 with 47% exceeding the suggested Asian cut-off point for obesity (BMI > or = 25). Ethnic difference in clinical characteristics included BMI, blood pressure, mode of treatment and degree of insulin resistance. Most patients had a clinical presentation of Type 2 diabetes. About 10% had a classical combination of ketotic presentation, presence of autoimmune-markers and documented insulin deficiency indicative of Type 1 diabetes. Forty-eight percent were receiving oral hypoglycaemic agents (OHAs) while 31% were on diet only, 18% were receiving insulin and 2% were on a combination of insulin and OHA.
    CONCLUSION: Young onset diabetes patients in Asia represent a heterogeneous group in terms of their clinical and biochemical characteristics and classical Type 1 diabetes is relatively uncommon. The 5-year follow up study will determine the progress of these patients and help to clarify the natural history.
    Matched MeSH terms: Diabetes Mellitus/ethnology*; Diabetes Mellitus, Type 2/ethnology
  4. Jan Mohamed HJ, Yap RW, Loy SL, Norris SA, Biesma R, Aagaard-Hansen J
    Asia Pac J Public Health, 2015 Mar;27(2):123-35.
    PMID: 25524952 DOI: 10.1177/1010539514562447
    This systematic review aimed to examine trends in overweight, obesity, and type 2 diabetes mellitus (T2DM) among Malaysian adults, and to identify its underlying determinants. A review of studies published between 2000 and 2012 on overweight, obesity, and T2DM was conducted. The Cochrane library of systematic reviews, MEDLINE, EMBASE, Biosis, Scopus, and MyJurnal digital database were searched. According to national studies, the prevalence of overweight increased from 26.7% in 2003 to 29.4% in 2011; obesity prevalence increased from 12.2% in 2003 to 15.1% in 2011, and T2DM prevalence was reported as 11.6% in 2006 and 15.2% in 2011. Distal determinants of increased risk of overweight, obesity, and T2DM were as follows: female, Malay/Indian ethnicity, and low educational level. The limited number of studies on proximal determinants of these noncommunicable diseases (NCDs) indicated that an unhealthy diet was associated with increased risk, whereas smoking was associated with decreased risk. However, more studies on the proximal determinants of overweight, obesity, and T2DM within the Malaysian context are needed. Overall, our findings provide insights for designing both future investigative studies and strategies to control and prevent these NCDs in Malaysia.
    Matched MeSH terms: Diabetes Mellitus, Type 2/ethnology; Overweight/ethnology
  5. Yary T, Aazami S
    Lipids Health Dis, 2011;10:151.
    PMID: 21864357 DOI: 10.1186/1476-511X-10-151
    The incidence of depression is expected to increase over the next 20 years, and many people will have to deal with it. It has been reported that up to 40% of university students experience levels of depression. Several negative consequences are associated with depression symptoms, such as memory impairment, suicide, and substance abuse. Recently, researchers have been studying possible associations between depression and polyunsaturated fatty acids (PUFAs), which may modify depression symptoms. The aim of the present study was to find an association between PUFA levels and depression among Iranian postgraduate students in Malaysia.
    Matched MeSH terms: Depression/ethnology*; Iran/ethnology
  6. Nor Azmaniza A, Shamsuddin K, Aazami S
    MyJurnal
    There is a growing interest in research on satisfaction with healthcare provider (HCP) and HCP- patient communication as a measure of healthcare quality of HCP’s communication competency. However, many communication assessments were not comprehensive measures and are not entirely accurate in measuring what is supposed to be measured. This study aimed at assessing the validity and reliability of a newly developed HCP-PC instrument in a Malaysian primary care setting. The HCP-PC instrument was developed using items adapted from existing instruments as well as self-developed items. A pilot study involving 277 clients of an outpatient clinic was conducted in HKL using the proposed instrument which was distributed immediately after face to face consultation. The content validity and Cronbach alpha reliability were assessed. Factor analysis constructed 3 components, exchanging information (EI), socioemotional behaviour (SB) and communication style (CS). All items loaded on the corresponding component with factor loading ≥0.6, suggesting that all items in the respective component are measuring the same direction. PCA of the final 30 items explain 61.98% of the total variance with 6.66%, 47.18% and 8.13% explained by EI, SB and CS respectively. Component-based reliability show strong internal consistency with Cronbach alpha, αEI= 0.92, αSB= 0.96 and αCS= 0.70. The pilot study supported the instrument validity and reliability after initial tests. However, further study needs to be done to confirm its construct validity to help establish a valid and reliable HCP-PC instrument for measuring patient satisfaction with HCP-PC that can be used in primary care setting.

    Study site: outpatient clinic was conducted in HKL
    Matched MeSH terms: Malaysia/ethnology
  7. Mohamad Isa II, Abu Bakar S, Ab Rahman AK
    J Med Virol, 2020 08;92(8):1173-1181.
    PMID: 31957025 DOI: 10.1002/jmv.25680
    The impact of sociodemographic and clinical factors on immune recovery and viral load suppression among HIV-1 positive patients treated with HAART particularly in Malaysia is largely unknown. This cross-sectional study enrolled 170 HIV-1-infected individuals of three major ethnicities who attended three HIV outpatient clinics in Malaysia. Questionnaire was used to obtain sociodemographic data while CD4 count and viral load data were gathered from hospital's record. Multiple factors were assessed for their predictive effects on CD4 count recovery (≥500 cells/mm3 ) and viral load suppression (≤50 copies/mL) using binary logistic regression. Most of the subjects were male (149/87.6%), in the age group 30 to 39 years old (78/45.9%) and got infected via homosexual contact (82/48.2%). Indians were associated with 11 times higher chance for CD4 recovery as compared to Malays at 8 to 12 months of HAART (adjusted OR: 10.948, 95% CI: 1.873, 64.001, P = .008). Viral load suppression was positively influenced by intravenous drug use (IVDU) status (adjusted OR: 35.224, 95% CI: 1.234, 1000.489, P = .037) at 4 to 6 months of HAART. Higher pretreatment CD4 count was a positive predictor for both initial immunological and virological responses while higher pretreatment viral load was a negative predictor for virological suppression only. In conclusion, ethnicity plays a significant role in determining early immune reconstitution in Malaysia, besides pretreatment CD4 count. Further studies are needed to identify possible biological factors underlying this association.
    Matched MeSH terms: HIV Infections/ethnology
  8. Thevi T, Abas AL
    Kathmandu Univ Med J (KUMJ), 2019 4 1;17(66):101-106.
    PMID: 32632055
    Background Since cataract is the leading cause of blindness and no study has been done on the surgical incidence trends, we conducted this research in Melaka. Objective To describe incidences of cataract surgery according to basic demographic variables and types of surgery performed. Method Using the National Eye Database (NED), we performed descriptive statistics calculating incidence rates per 1,000 population by demographic features and types of cataract operations to look at the trends of surgeries in the population. Statistics for population were obtained from the department of statistics. Result From 2007-2010, 6270 patients mostly 60-69 years underwent cataract surgery. Phacoemulsification (78.2%) was the commonest surgery performed. The annual incidence rate of cataract surgery reduced from 2.05 per 1000 population in 2007 to 2.02 per 1000 population in 2010 (p<0.05). Incidence rates for those aged 60 and above rose while for those aged below nine years it declined. Indians had the highest incidence rates followed by Chinese and Malays per 1000 population. Females had a higher incidence rate although there was a declining trend over the years. Conclusion Cataract surgery rates showed a decline. Public health education and awareness on detection and operating upon cataracts should be increased and especially targeted towards vulnerable groups such as women, individuals of Indian ethnicity and those aged 50 years and above.
    Matched MeSH terms: Cataract/ethnology*
  9. Cheah YK, Azahadi M, Phang SN, Abd Manaf NH
    Psychiatry Res, 2018 03;261:319-324.
    PMID: 29331849 DOI: 10.1016/j.psychres.2017.12.086
    Suicide has become a serious matter in both developed and developing countries. The objective of the present study is to examine the factors affecting suicidal behaviour among adults in Malaysia. A nationally representative data which consists of 10,141 respondents is used for analysis. A trivariate probit model is utilised to identify the probability of having suicide ideation, suicide plan and suicide attempt. Results of the regression analysis show that to ensure unbiased estimates, a trivariate probit model should be used instead of three separate probit models. The determining factors of suicidal behaviour are income, age, gender, ethnicity, education, marital status, self-rated health and being diagnosed with diabetes and hypercholesterolemia. The likelihood of adopting suicidal behaviour is lower among higher income earners and older individuals. Being male and married significantly reduce the propensity to engage in suicidal behaviour. Of all the ethnic groups, Indian/others displays the highest likelihood of adopting suicidal behaviour. There is a positive relationship between poor health condition and suicide. Policies targeted at individuals who are likely to adopt suicidal behaviour may be effective in lowering the prevalence of suicide.
    Matched MeSH terms: Suicide, Attempted/ethnology
  10. Sivanesaratnam V, Abd Rahman A
    Med J Malaysia, 1984 Mar;39(1):69-72.
    PMID: 6513843
    A review of our experience of 916 cases ofpartial bilateral vasectomy performed under local anaesthesia at the University Hospital, Kuala Lumpur during the
    period between January 1971 and June 1980 is presented. Minor post-operative complications occurred in 5.8% of cases with a low post-operative infection rate of 1.2%. In 35% ofpatients, persistence of non-motile sperms in the semen were seen after at least ten ejaculations in each instance. In four of these cases non-motile sperms continued to persist into the sixth month of follow-up even after at least 50 ejaculations in each instance.
    Matched MeSH terms: China/ethnology; India/ethnology
  11. Koo HC, Poh BK, Abd Talib R
    Nutrients, 2018 Jan 30;10(2).
    PMID: 29385769 DOI: 10.3390/nu10020156
    Background: The GReat-Child Trial was a quasi-experimental intervention that has emphasized whole grain as a strategy to manage childhood obesity. Methods: Two schools in Kuala Lumpur with similar demographic characteristics were assigned as intervention (IG) and control (CG). Eligibility criteria were overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming wholegrain foods in their 3-day diet-recall during screening were excluded. A total of 63 children (31 IG; 32 CG) completed the entire intervention program. The IG children underwent six 30-min nutrition education lessons and had school delivery of wholegrain food on a daily basis over a 12-week period. Parents of IG children attended 1-h individual diet counseling. Anthropometric outcomes including BMI-for-age z-score (BAZ), body fat percentage and waist circumference were measured at baseline [T0], post-intervention [T1] (3rd month) and follow-up [T2] (9th month). Results: IG showed significantly lower BAZ (weighted difference: -0.12; 95% CI: -0.21, -0.03; p = 0.009), body fat percentage (weighted difference: -2.6%; 95% CI: -3.7, -1.5; p < 0.001) and waist circumference (weighted difference: -2.4 cm; 95% CI: -3.8, -1.0; p = 0.001) compared to CG. IG reported significantly lower body fat percentage (weighted difference: -3.4%; 95% CI: 1.8, 5.0; p < 0.001) and waist circumference (weighted difference: -2.1 cm; 95% CI: -3.7, -0.5; p = 0.014) at T1 compared to T0. Conclusions: The GReat-Child Trial made a positive impact in managing childhood obesity. It can be incorporated into childhood obesity intervention programs that are being implemented by the policy makers.
    Matched MeSH terms: Overweight/ethnology; Pediatric Obesity/ethnology
  12. Lim LC, Tan HH, Lee LH, Tien SL, Abdul Ghafar A
    Ann Acad Med Singap, 1999 Mar;28(2):252-5.
    PMID: 10497677
    Resistance to activated protein C (APC-R) is the commonest inherited cause of thrombosis among Caucasians. Few studies have been carried out on its prevalence in Asians. We conducted a prospective study on 60 patients with thromboembolism to determine its prevalence in our local population. The Factor V Leiden (VaQ506) mutation associated with this condition was detected by amplification of the Factor V gene by polymerase chain reaction (PCR) and digestion of the fragment with Mnl I. Three patients were found to be heterozygous for this mutation. None of the 3 patients had other concomitant hypercoagulable states. In addition, we studied the prevalence of this condition in Malays which was found to be 0.5%. Our study suggests that the incidence of APC-R is much lower here compared to the West.
    Matched MeSH terms: China/ethnology; India/ethnology; Malaysia/ethnology
  13. Woon KC, Thong YL, Abdul Kadir R
    Aust Orthod J, 1989 Mar;11(1):45-8.
    PMID: 2640092
    This survey outlines the proportion of the various features of occlusion in the permanent dentition of the three ethnic races, Chinese, Malay and Indian in Malaysia. The mean age of the high school children surveyed was 16.4 years. The Chinese and Malays had almost similar distribution of the different types of occlusion. There was a significantly higher prevalence of Class III occlusion among the Chinese and Malays as compared to the Indians. In addition, an edge to edge incisor relationship seemed to be a norm in the Chinese (54%) and Malays (50%) whilst the overjet of between 2-4 mm and the overbite of between 1/3 to 2/3 was more normal to Indians (50%). A crowded dentition was also a norm for the three races.
    Matched MeSH terms: China/ethnology; India/ethnology
  14. Poh BK, Wong YP, Abdul Karim N
    Malays J Nutr, 2005;11(1):1-21-.
    MyJurnal
    Traditionally, Chinese women adhere to special dietary practices during the month following childbirth. This paper discusses the dietary practices and food taboos practised by Chinese women in Kuala Lumpur. A total of 134 Chinese mothers of children below one year were recruited from three Maternal and Child Health Clinics and Maternity Hospital, Kuala Lumpur. Questionnaires and in-depth interviews were used to obtain information on socioeconomic background, dietary practices, food taboos and cooking methods during the confinement period. Food intake was assessed by multiple 24-hour dietary recall among 34 mothers during their confinement month (zuo yuezi). Body weight and height were measured, and body mass index calculated. Majority of the respondents had secondary school education (77.6%), household income between RM1001 and RM3000 (64%), and were homemakers (48.5%). The women were aged 18-39 years, and 68% were of normal weight. Most women (82%) practised 30 days of confinement, during which they adhered to special dietary practices. The diet was directed at attaining yin-yang (cold-hot) balance, whereby “hot” foods were most commonly used and “cold” foods were avoided. Ginger, rice wine and sesame seed oil, considered “hot” foods, were used in large amounts in the cooking. Rice, chicken and pork were also consumed in large amounts. Most vegetables and fruits were considered “cold” and were prohibited during confinement. Most mothers drank specially-prepared teas boiled from Chinese herbs. Mean energy intake was 19% below RNI, while mean protein intake was 93% above RNI (NCCFN, 2005). Mean intakes of thiamin, riboflavin and niacin were above 75% of RNI, while vitamins A and C were at half of RNI or less. Mean iron and calcium intakes were at 222% and 67% of RNI, respectively. It is concluded that most Chinese women in Kuala Lumpur do conform to special dietary practices during zuo yuezi.

    Study site: three Maternal and Child Health Clinics and Maternity Hospital, Kuala Lumpur
    Matched MeSH terms: China/ethnology
  15. Najafi-Sharjabad F, Zainiyah Syed Yahya S, Abdul Rahman H, Hanafiah Juni M, Abdul Manaf R
    Glob J Health Sci, 2013 Sep;5(5):181-92.
    PMID: 23985120 DOI: 10.5539/gjhs.v5n5p181
    Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women.
    Matched MeSH terms: Contraception Behavior/ethnology*
  16. Mohamed Saini S, Nik Jaafar NR, Sidi H, Midin M, Mohd Radzi A, Abdul Rahman AH
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S76-81.
    PMID: 23410635 DOI: 10.1016/j.comppsych.2012.12.005
    The risk variants have been shown to vary substantially across populations and a genetic study in a heterogeneous population might shed a new light in the disease mechanism. This preliminary study aims to determine the frequency of the serotonin transporter gene polymorphism (5-HTTLPR) in the three main ethnic groups in Malaysia and its association with bipolar disorder.
    Matched MeSH terms: Bipolar Disorder/ethnology; Ethnic Groups/ethnology; Malaysia/ethnology
  17. Ghazali DM, Rehman A, Abdul Rahman AR
    Clin Chim Acta, 2008 Feb;388(1-2):46-50.
    PMID: 17977523 DOI: 10.1016/j.cca.2007.10.002
    BACKGROUND: Knowledge of candidate gene polymorphisms in a population is useful for a variety of gene-disease association studies, particularly for some complex traits. A single nucleotide variant of the angiotensinogene gene (AGT M235T) and endothelial nitric oxide synthase gene (eNOS G894T) have been associated with hypertension.
    METHOD: A cross-sectional study consisting of 200 hypertensives and 198 age- and sex-matched controls was conducted. Subjects involved in this study were pure Malay for 3 generations. The AGT M235T and eNOS G894T polymorphisms were determined by PCR-RFLP method.
    RESULTS: The distribution of M235T genotype in the population was 3.5% for MM, 30.4% for MT and 66.1% for TT. No significant difference was observed in genotype (chi(2)=1.30, p=0.52) and allele (chi(2)=0.87, p=0.35) frequencies among the 2 study group. In contrast, the distribution of genotypes for G894T was 74.1% for GG, 24.6% for GT and 1.3% for TT, respectively. Similarly, no significant difference was observed in genotype (chi(2)=0.94, p=0.33) and allele (chi(2)=0.60, p=0.44) frequencies between both study groups.
    CONCLUSION: The AGT M235T and eNOS G894T polymorphisms are unlikely to play an important role in the pathogenesis of hypertension in Malays.
    Study site: Outpatient clinic, Hospital Universiti Sains Malaysia (HUSM); government clinics, Kelantan, Malaysia.
    Matched MeSH terms: Malaysia/ethnology
  18. Athar PP, Norhan NA, Abdul Rahman MS
    Malays J Med Sci, 2007 Jan;14(1):75-8.
    PMID: 22593658 MyJurnal
    Schwannoma of the cervical sympathetic chain is an extremely rare nerve tumour. We report an unusual swelling in a 41-year-old female who presented with an asymptomatic solitary mass in the right parapharyngeal space. Clinical examination and computed tomography showed displaced carotid artery in an antero-medial direction. Surgical excision of the lesion was carried out and histological examination revealed an Ancient Schwannoma.
    Matched MeSH terms: Malaysia/ethnology
  19. Teo PH, Chong YH, Abdul Rahman MZ
    Med J Malaysia, 1988 Jun;43(2):125-33.
    PMID: 3237128
    Matched MeSH terms: Coronary Disease/ethnology
  20. Shaharir SS, Mohamed Said MS, Mohd R, Abdul Cader R, Mustafar R, Abdul Rahman R
    PLoS One, 2019;14(9):e0222343.
    PMID: 31539383 DOI: 10.1371/journal.pone.0222343
    Flare of Systemic Lupus Erythematosus (SLE) may occur during pregnancy and puerperium. We studied the prevalence and factors associated with SLE relapse during pregnancy and post-partum period in a multi-ethnic SLE cohort. Consecutive SLE patients who attended the outpatient clinic were reviewed for previous history of pregnancies in our institution. Patients who had a complete antenatal, delivery, and post-partum follow up were included. Their medical records were retrospectively analysed to assess the disease activity at pre-pregnancy/conception, during antenatal, and post-partum period. Presence of flare episodes during pregnancy and puerperium were recorded. The pregnancy outcomes recorded include live birth, foetal loss, prematurity and intra-uterine growth restrictions (IUGR). Univariate and multivariable logistic regression with generalized estimating equations (GEE) analyses were performed to determine the factors associated with disease relapse and the pregnancy outcomes. A total of 120 patients with 196 pregnancies were included, with a live birth rate of 78.6%. Four (2.0%) were diagnosed to have SLE during pregnancy. The flare rate in pregnancy was 40.1% while post-partum 17.4%. Majority of the relapse in pregnancy occurred in haematological system (62.3%) followed by renal (53.2%), musculoskeletal (22.1%), and mucocutaneous (14.3%). In GEE analyses, active disease at conception was the independent predictor of SLE relapse during and after pregnancy, whereas older maternal age and Malay ethnicity were associated with higher flare during post-partum. HCQ use was significantly associated with reduced risk of flare in univariate analysis but it was no longer significant in the GEE analyses. Presence of disease flare in pregnancy was significantly associated with prematurity. In conclusion, pregnancy in SLE need to be planned during quiescent state as pre-pregnant active disease was associated with disease relapse in both during and after pregnancy. Malay patients had an increased risk of post-partum flare but further larger prospective studies are needed to confirm the association between pregnancies in the different ancestral background.
    Matched MeSH terms: Lupus Erythematosus, Systemic/ethnology; Pregnancy Complications/ethnology
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