Maternal and Fetal Outcomes in Iranian Patients with Systemic Lupus Erythematosus: A Five-Year Retrospective Study of 60 Pregnancies.
Adolescent
Adult
Antibodies, Antiphospholipid
/ blood
Delivery, Obstetric
/ statistics & numerical data
Female
Humans
Infant, Newborn
Iran
/ epidemiology
Lupus Erythematosus, Systemic
/ complications
Pregnancy
Pregnancy Complications
/ etiology
Pregnancy Outcome
/ epidemiology
Retrospective Studies
Symptom Flare Up
Young Adult
Iran
Systemic lupus erythematosus
hypertension
lupus flare
lupus nephritis
outcome
pregnancy.
Journal
Current rheumatology reviews
ISSN: 1875-6360
Titre abrégé: Curr Rheumatol Rev
Pays: United Arab Emirates
ID NLM: 101261938
Informations de publication
Date de publication:
2019
2019
Historique:
received:
16
11
2018
revised:
16
01
2019
accepted:
17
01
2019
pubmed:
29
1
2019
medline:
24
4
2020
entrez:
29
1
2019
Statut:
ppublish
Résumé
As a multisystem autoimmune disease, Systemic Lupus Erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE. Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016. The mean age of the patients was 29.28±4.6 years and mean disease duration was 5.09±4.2 years. Live birth rate was 83.3% after exclusion of elective abortions. There were 50 live births, 3 neonatal deaths, 3 spontaneous abortions and 7 stillbirths. 9 (15%) women developed preeclampsia and there was 1 (1.6%) case of HELLP syndrome. Lupus flares occurred in 27 (45%) patients during pregnancy. Preterm delivery occurred in 11.6% of pregnancies. Skin and joints were the most frequently affected organs. Patients with previous lupus nephritis (n=18) were associated with a higher risk of maternal complication, but fetal outcomes were similar in both groups. Cesarean rate was about 66%, mostly related to fetal indications (50%). Pregnancies in most women with pre-existing SLE can now be managed with successful results although presence of previous lupus nephritis is still a major risk factor for adverse maternal outcomes. In our study, fetal outcome was not different between patients with lupus nephritis compared with the patients without nephritis who were under treatments. Hence, to achieve favorable long-term results, we recommend regular multispecialty treatment approaches and progestational counseling for women with SLE.
Sections du résumé
BACKGROUND
BACKGROUND
As a multisystem autoimmune disease, Systemic Lupus Erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE.
METHODS
METHODS
Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016.
RESULTS
RESULTS
The mean age of the patients was 29.28±4.6 years and mean disease duration was 5.09±4.2 years. Live birth rate was 83.3% after exclusion of elective abortions. There were 50 live births, 3 neonatal deaths, 3 spontaneous abortions and 7 stillbirths. 9 (15%) women developed preeclampsia and there was 1 (1.6%) case of HELLP syndrome. Lupus flares occurred in 27 (45%) patients during pregnancy. Preterm delivery occurred in 11.6% of pregnancies. Skin and joints were the most frequently affected organs. Patients with previous lupus nephritis (n=18) were associated with a higher risk of maternal complication, but fetal outcomes were similar in both groups. Cesarean rate was about 66%, mostly related to fetal indications (50%).
CONCLUSION
CONCLUSIONS
Pregnancies in most women with pre-existing SLE can now be managed with successful results although presence of previous lupus nephritis is still a major risk factor for adverse maternal outcomes. In our study, fetal outcome was not different between patients with lupus nephritis compared with the patients without nephritis who were under treatments. Hence, to achieve favorable long-term results, we recommend regular multispecialty treatment approaches and progestational counseling for women with SLE.
Identifiants
pubmed: 30686262
pii: CRR-EPUB-96129
doi: 10.2174/1573397115666190125162248
doi:
Substances chimiques
Antibodies, Antiphospholipid
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
321-328Informations de copyright
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