Retrospective Clinical Analysis of Pregnant Patients With Systemic Lupus Erythematosus
- VernacularTitle:系统性红斑狼疮合并妊娠的回顾性分析
- Author:
Jin-hui CUI
1
;
Ping LI
1
;
Ling LI
1
;
Zhao-ran MENG
1
;
Jian-hui FAN
1
Author Information
1. Department of Obstetrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
- Publication Type:Journal Article
- Keywords:
systemic lupus erythematosus;
pregnancy outcomes;
lupus flares
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(3):473-478
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To study the impact of lupus flares on pregnancy outcomes in pregnant patients with systemic lupus erythematosus(SLE), and analyze the risk factors of adverse pregnancy outcomes. 【Methods】 Data were obtained from 95 pregnancies of 89 patients with SLE between January 1, 2013 and December 31, 2018 at The Third Affiliated Hospital of Sun Yat-sen University and its Lingnan Branch. The relationship between lupus flares and pregnancy outcomes, and the risk factors for adverse pregnancy outcomes were analyzed. 【Results】 ①The disease changes were evaluated by SLEDI and divided into two groups. Lupus flares occurred in 39 pregnancies(group A), and stable lupus disease was observed in 56 pregnancies(group B). The activity rate of lupus flares was 41.05%, compared with pregnancies in patients with stable lupus disease before pregnancy, pregnancies in patients with first onset pregnancy and unplanned pregnancy before pregnancy had higher lupus flares during pregnancy(100% vs. 28.21%, P < 0.05). ②Adverse pregnancy outcomes: the incidence of fetal loss, preterm labor, intrauterine growth retardation, preeclampsia and active lupus nephritis in group A was 20.51%, 35.90%, 43.59%, 17.95% and 41.02%, respectively, which was significantly higher than those of the group B(1.8%, 14.29%, 17.86%, 3.57% and 0, respectively) (P < 0.05). There was no difference in fetal distress, neonatal asphyxia and neonatal lupus between the two groups(10.26% vs. 1.79%, 7.69% vs. 1.79%, 2.56% vs. 0, respectively; P > 0.05). ③The Logistic regression analysis showed that unplanned pregnancy before pregnancy, active lupus nephritis during pregnancy, aPL positive and antiSSA positive were risk factors for adverse pregnancy outcomes(P < 0.05) . 【Conclusions】 Conception timing for pregnant women is crucial to lupus flares during pregnancy. Lupus flares during pregnancy increase the incidence of fetal loss, preterm labor, intrauterine growth retardation, preeclampsia and active lupus nephritis. Unplanned pregnancy before pregnancy, active lupus nephritis during pregnancy, aPL positive and antiSSA positive are associated with adverse pregnancy outcomes.
