Are pregnancies with lupus but without APS of good prognosis?
Journal
Autoimmunity reviews
ISSN: 1873-0183
Titre abrégé: Autoimmun Rev
Pays: Netherlands
ID NLM: 101128967
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
10
10
2019
accepted:
13
10
2019
pubmed:
1
3
2020
medline:
4
4
2020
entrez:
1
3
2020
Statut:
ppublish
Résumé
Pregnancies in women with systemic lupus erythematosus (SLE) are at risk of unfavorable perinatal outcomes, especially when antiphospholipid antibody syndrome (APS) is present. Their prognosis is less clear in other situations. To assess pregnancy prognosis in women with SLE but not APS compared with a control series and determine the poor prognostic factors, if any, detectable before 15 weeks' gestation. This retrospective case-control study included 137 women with SLE, including 114 without APS, and 274 control women. Unfavorable perinatal outcome was defined by perinatal death (≥ 22 weeks of gestation) or preterm delivery ≤35 weeks. Pregnancies of the 114 women with SLE but not APS were at more than twice the risk of unfavorable perinatal outcomes compared with those in the control group (18/114 (15.8%) vs 21/274 (7.7%), OR 2.3, 95% 1.1-4.7). After logistic regression, three factors detectable before 15 weeks were associated with an unfavorable perinatal outcome: i. proteinuria and/or hypertension (in 19.3% of the pregnancies) ii. lack of cutaneous lupus (26.3%), and iii. a history of thrombocytopenia-leukopenia-anemia (19.3%). When these factors were absent, the risk of a poor perinatal outcome was very low (3.3%) but increased strongly for pregnancies with one (22.2%) or at least two (44.4%) of these factors. Among women with SLE but not APS in the first trimester, only the presence of risk factors increases the likelihood of an unfavorable perinatal outcome. Pregnancies with SLE but not APS are at risk of unfavorable perinatal outcomes only if risk factors are present.
Sections du résumé
BACKGROUND
BACKGROUND
Pregnancies in women with systemic lupus erythematosus (SLE) are at risk of unfavorable perinatal outcomes, especially when antiphospholipid antibody syndrome (APS) is present. Their prognosis is less clear in other situations.
OBJECTIVES
OBJECTIVE
To assess pregnancy prognosis in women with SLE but not APS compared with a control series and determine the poor prognostic factors, if any, detectable before 15 weeks' gestation.
MATERIAL AND METHODS
METHODS
This retrospective case-control study included 137 women with SLE, including 114 without APS, and 274 control women. Unfavorable perinatal outcome was defined by perinatal death (≥ 22 weeks of gestation) or preterm delivery ≤35 weeks.
RESULTS
RESULTS
Pregnancies of the 114 women with SLE but not APS were at more than twice the risk of unfavorable perinatal outcomes compared with those in the control group (18/114 (15.8%) vs 21/274 (7.7%), OR 2.3, 95% 1.1-4.7). After logistic regression, three factors detectable before 15 weeks were associated with an unfavorable perinatal outcome: i. proteinuria and/or hypertension (in 19.3% of the pregnancies) ii. lack of cutaneous lupus (26.3%), and iii. a history of thrombocytopenia-leukopenia-anemia (19.3%). When these factors were absent, the risk of a poor perinatal outcome was very low (3.3%) but increased strongly for pregnancies with one (22.2%) or at least two (44.4%) of these factors.
CONCLUSION
CONCLUSIONS
Among women with SLE but not APS in the first trimester, only the presence of risk factors increases the likelihood of an unfavorable perinatal outcome.
PRECIS
CONCLUSIONS
Pregnancies with SLE but not APS are at risk of unfavorable perinatal outcomes only if risk factors are present.
Identifiants
pubmed: 32112993
pii: S1568-9972(20)30037-9
doi: 10.1016/j.autrev.2020.102489
pii:
doi:
Types de publication
Letter
Langues
eng
Sous-ensembles de citation
IM
Pagination
102489Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.