Abstract
ObjectiveThis study aimed to examine the frequency and risk factors of complications during pregnancy in women with systemic lupus erythematosus (SLE).MethodsThe medical records of patients with SLE and age-matched controls at Ajou University Hospital were collected. Clinical features and pregnancy complications in women with SLE were compared to those of the controls. Multivariate logistic regression analysis was performed to determine the predictors of adverse maternal and fetal outcomes.ResultsWe analyzed 163 pregnancies in patients with SLE and 596 pregnancies in the general population; no significant differences regarding demographic characteristics were noted. Patients with SLE experienced a higher rate of stillbirth (OR 13.2), preeclampsia (OR 4.3), preterm delivery (OR 2.8), intrauterine growth retardation (OR 2.5), admission to neonatal intensive care unit (OR 2.2), and emergency cesarean section (OR 1.9) than the control group. Multivariate regression analysis revealed that thrombocytopenia, low complement, high proteinuria, high SLE Disease Activity Index (SLEDAI), low Lupus Low Disease Activity State (LLDAS) achievement rate, and high corticosteroid (CS) dose were associated with adverse pregnancy outcomes. In the receiver-operating characteristic curve analysis, the optimal cutoff value for the cumulative and mean CS doses were 3500 mg and 6 mg, respectively.ConclusionPregnant women with SLE have a higher risk of adverse pregnancy outcomes. Pregnancies are recommended to be delayed until achieving LLDAS and should be closely monitored with the lowest possible dose of CS.
Publisher
The Journal of Rheumatology
Subject
Immunology,Immunology and Allergy,Rheumatology
Reference46 articles.
1. Pregnancy outcomes in systemic lupus erythematosus (SLE) women;Kalok;Horm Mol Biol Clin Investig,2019
2. Petri M , Kallas R. Lupus in pregnancy. Contemp Ob Gyn 2019;64 No 03. [Internet. Accessed January 21, 2021.] Available from: www.contemporaryobgyn.net/pregnancy-and-birth/lupus-pregnancy
3. Ordi-Ros J , Marce CS , Cortes-Hernandez J. Lupus pregnancy: risk factors and management. In: Lionaki S , ed. Lupus – new advances and challenges. [Internet. Accessed February 8, 2021.] Available from: www.intechopen.com/books/lupus-new-advances-and-challenges/lupus-pregnancy-risk-factors-and-management
4. Chakravarty EF , Sammaritano LR. Pregnancy and autoimmune disease, reproductive and hormonal issues. In: Wallace D , Hahn B. Dubois’ lupus erythematosus and related syndromes 9th ed. Elsevier; 2019:499-519.
5. Frequency of lupus flare in pregnancy: the Hopkins Lupus Pregnancy Center experience;Petri;Arthritis Rheum,1991
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