Clinical and serological risk factors of systemic lupus erythematosus outcomes during pregnancy

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• 作者：Hala Ali Gaballa^a ; Eman El-Dessoky El-Shahawy^a ; ^{aymony_s@yahoo.com} ; ^{eman_d@zu.edu.eg} ; Doaa Salah Atta^a ; Ehab Foad Gerbash^b
• 关键词：SLE ; Pregnancy ; Risk factors ; Maternal outcome ; Fetal outcome
• 刊名：The Egyptian Rheumatologist
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：34
• 期：4
• 页码：159-165
• 全文大小：580 K

文摘

Introduction

SLE is an important risk factor for mother and fetus during pregnancy.

Aim of the work

To identify clinical and serological risk factors that may cause poor maternal and fetal outcomes in pregnant systemic lupus erythematosus (SLE) patients.

Patients and methods

Forty selected SLE pregnant women (group A) versus 35 non-pregnant SLE patients (group B). SLE disease activity index (SLEDAI) and flares were evaluated for both groups. Laboratory investigations included double stranded DNA, anticardiolipin antibodies (aCL), and complements (C3 & C4). SLE pregnant patients were followed up in the second and third trimesters by ultrasonography and fetal Doppler were done to assess fetal outcome. Risk factors for poor maternal and fetal outcome were recorded.

Results

SLEDAI was increased in both groups more in group A. Lupus flares were increased during pregnancy as it occurred in (62.5 % ) of group A compared to (37.14 % ) in group B where severe flares were more frequent in group A. Gestational hypertension and active SLEDAI were found statistically significant for poor maternal outcome. Fetal outcome included full term 37.5 % , prematurity 25 % , intra-uterine growth retardation (IUGR) 22.5 % , stillbirth 12.5 % , abortion 7.5 % and congenital heart block (CHB) 2.5 % . Factors significantly associated with poor fetal outcome were severe flares and active renal disease where fetal loss significantly associated with aCL antibodies. Full term was more common in patients with no flares.

Conclusion

These data demonstrate that pregnancy in SLE patients should be considered as a high-risk pregnancy and conception should be planned during a quiescent period. Close monitoring for optimal disease control of flares, lupus nephritis, gestational hypertension and aCL antibodies is recommended.