15 October 2026
The 2026 MBRRACE-UK report highlights avoidable risks and continued inequalities in maternal healthcare and calls for more proactive, coordinated care for women with pre-existing medical conditions before, during and after pregnancy. Its findings include important lessons for rheumatology teams supporting women with systemic lupus erythematosus (SLE), connective tissue disease (CTD) and other inflammatory rheumatic diseases.
Headline findings
Across the UK, 252 women died during pregnancy or within six weeks of birth in 2022–2024 - a maternal death rate 20% higher than in 2009–2011. Pre-existing medical conditions affected 60% of those who died, while the risk remained higher among Black women, women living in the most deprived areas and women aged over 35.
Key findings for rheumatology
- Connective tissue disease: Six women died from connective tissue disorders during the triennium, including four from complications of SLE.
- Haemophagocytic lymphohistiocytosis (HLH): Three deaths were attributed to HLH, including one involving a woman with SLE. This is consistent with around one maternal death each year.
- Pre-pregnancy care: Some women with complex CTD had not received pre-pregnancy counselling or appropriate advice about deferring pregnancy and using effective contraception.
- Fragmented care: Women with SLE or CTD could face a heavy burden of appointments and poorly coordinated care. The report emphasises senior oversight, effective multidisciplinary working and joined-up care.
- Biologic medicines: The morbidity review focused on women receiving biologic agents during pregnancy, reinforcing the need for medication advice, monitoring and guidance on vaccination for infants exposed to biologic medicines.
What rheumatology teams should do
Reflecting the report’s theme, “Proactive, not reactive, maternity care”, rheumatology services should provide timely pre-pregnancy counselling and discuss future pregnancies, medication and contraception after birth. For further information, consult our guideline on Prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids and look out for our upcoming guideline on female reproductive health in inflammatory rheumatic disease.
Pregnancy-related risk begins before conception and can continue well beyond birth. Proactive counselling, continuity of care and rapid recognition of deterioration are therefore central to improving safety.
To receive quarterly updates on reproductive health, join our Pregnancy and Rheumatic Disease Special Interest Group by emailing Dr Bethan Goulden (bethan.goulden@nhs.net).