Use of antimalarial drugs is associated with a lower risk of preeclampsia in lupus pregnancy: A prospective cohort study.
antimalarials
preeclampsia
pregnancy
systemic lupus erythematosus
Journal
International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
24
05
2019
revised:
06
03
2020
accepted:
07
03
2020
pubmed:
1
4
2020
medline:
7
4
2021
entrez:
1
4
2020
Statut:
ppublish
Résumé
Several factors have been associated with the development of preeclampsia in women with systemic lupus erythematosus (SLE). To identify risk factors associated with preeclampsia in patients with SLE and its impact on fetal outcomes. We studied a prospective cohort of pregnancies in women with SLE from January 2009 to December 2018. Demographic, clinical, serological and drug use characteristics were compared between patients who developed preeclampsia and those who did not, as well as the main neonatal outcomes. An adjusted logistic regression analysis was performed to identify factors potentially associated with preeclampsia. We studied 316 pregnancies of 20 or more weeks of gestation. A total of 46 pregnancies (14.5%) were complicated by preeclampsia. A higher frequency of active disease before pregnancy (24.4% vs 11.3%, P = .01) and history of lupus nephritis (56.5% vs 30.1%, P < .001) were found in those patients who developed preeclampsia compared to those who did not. Preeclampsia was associated with a higher rate of prematurity, births of very low birth weight, stillbirth, and neonatal death. The multivariate analysis showed that the activity of the disease before (relative risk [RR] 2.7, 95% CI 1.04-7.4, P = .04) and during pregnancy (RR 3.0, 95% CI 1.0-9.1, P = .04) was associated with the development of preeclampsia. The use of antimalarial drugs during pregnancy was associated with a lower risk of preeclampsia (RR 0.21, 95% CI 0.08-0.53, P < .001). Our study suggests that the use of antimalarial drugs during pregnancy reduces the risk of preeclampsia in lupus pregnancies.
Identifiants
pubmed: 32227576
doi: 10.1111/1756-185X.13830
doi:
Substances chimiques
Antimalarials
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
633-640Informations de copyright
© 2020 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Références
Clowse ME, Jamison M, Myers E, James AH. A national study of the complications of lupus in pregnancy. Am J Obstet Gynecol. 2008;199:127.e1-127.e6.
Bundhun PK, Soogund MZ, Huang F. Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy: a meta-analysis of studies published between years 2001-2016. J Autoimmun. 2017;79:17-27.
Saavedra MA, Cruz-Reyes C, Vera-Lastra O, et al. Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy. Clin Rheumatol. 2012;31:813-819.
Spinillo A, Beneventi F, Locatelli E, et al. The impact of unrecognized autoimmune rheumatic diseases on the incidence of preeclampsia and fetal growth restriction: a longitudinal cohort study. BMC Pregnancy Childbirth. 2016;16:313.
Wu J, Ma J, Zhang WH, Di W. Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis. Ther Clin Risk Manag. 2018;14:885-901.
Bramham K, Hunt BJ, Bewley S, et al. Pregnancy outcomes in systemic lupus erythematosus with and without previous nephritis. J Rheumatol. 2011;38:1906-1913.
Borella E, Lojacono A, Gatto M, et al. Predictors of maternal and fetal complications in SLE patients: a prospective study. Immunol Res. 2014;60:170-176.
Moroni G, Doria A, Giglio E, et al. Maternal outcome in pregnant women with lupus nephritis. A prospective multicenter study. J Autoimmun. 2016;74:194-200.
Phansenee S, Sekararithi R, Jatavan P, Tongsong T. Pregnancy outcomes among women with systemic lupus erythematosus: a retrospective cohort study from Thailand. Lupus. 2018;27:158-164.
Mecacci F, Simeone S, Cirami CL, et al. Preeclampsia in pregnancies complicated by systemic lupus erythematosus (SLE) nephritis: prophylactic treatment with multidisciplinary approach are important keys to prevent adverse obstetric outcomes. J Matern Fetal Neonatal Med. 2017;27:1-7.
Wu J, Ma J, Bao C, Di W, Zhang WH. Pregnancy outcomes among Chinese women with and without systemic lupus erythematosus: a retrospective cohort study. BMJ Open. 2018;8:e020909.
Chen D, Lao M, Zhang J, et al. Fetal and maternal outcomes of planned pregnancy in patients with systemic lupus erythematosus: a retrospective multicenter study. J Immunol Res. 2018;2018:2413637.
Rodrigues BC, Lacerda MI, Ramires de Jesús GR, et al. The impact of different classes of lupus nephritis on maternal and fetal outcomes: a cohort study of 147 pregnancies. Lupus. 2019;28:492-500.
Mayrink J, Costa ML, Cecatti JG. Preeclampsia in 2018: revisiting concepts, physiopathology, and prediction. Sci World J. 2018;2018:6268276.
Grandi SM, Filion KB, Yoon S, et al. Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications. Circulation. 2019;139:1069-1079.
Thilaganathan B, Kalafat E. Cardiovascular system in preeclampsia and beyond. Hypertension. 2019;73:522-531.
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum. 1997;40:1725.
Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definitive antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4:295-306.
Malik R, Kumar V. Hypertension in pregnancy. Adv Exp Med Biol. 2017;956:375-393.
Duff P. Premature rupture of the membranes in term patients: induction of labor versus expectant management. Clin Obstet Gynecol. 1998;41:883-891.
Saavedra MÁ, Miranda-Hernández D, Sánchez A, et al. Pregnancy outcomes in women with childhood-onset and adult-onset systemic lupus erythematosus: a comparative study. Rheumatol Int. 2016;36:1431-1437.
Ruperto N, Hanrahan LM, Alarcón GS, et al. International consensus for a definition of disease flare in lupus. Lupus. 2011;20:453-462.
Buyon JP, Kalunian KC, Ramsey-Goldman R, et al. Assessing disease activity in SLE patients during pregnancy. Lupus. 1999;8:677-684.
St Pierre A, Zaharatos J, Goodman D, Callaghan WM. Challenges and opportunities in identifying, reviewing, and preventing maternal deaths. Obstet Gynecol. 2018;131:138-142.
Frey HA, Klebanoff MA. The epidemiology, etiology, and costs of preterm birth. Semin Fetal Neonatal Med. 2016;21:68-73.
Blencowe H, Cousens S, Bianchi Jassir F, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4:e98-108.
Cutland CL, Lackritz EM, Mallett-Moore T, et al. Low birth weight: case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine. 2017;35:6492-6500.
World Health Organization. ICD-11 International Classification of Diseases 11th Revision [Internet]. April 8, 2018. https://icd.who.int/en. Accessed October 8, 2019.
Seo MR, Chae J, Kim YM, et al. Hydroxychloroquine treatment during pregnancy in lupus patients is associated with lower risk of preeclampsia. Lupus. 2019;28:722-730.
Lange T, Hansen KW, Sørensen R, Galatius S. Applied mediation analyses: a review and tutorial. Epidemiol Health. 2017;39:e2017035.
Skorpen CG, Lydersen S, Gilboe IM, et al. Influence of disease activity and medications on offspring birth weight, pre-eclampsia and preterm birth in systemic lupus erythematosus: a population-based study. Ann Rheum Dis. 2018;77:264-269.
Armaly Z, Jadaon JE, Jabbour A, Abassi ZA. Preeclampsia: novel mechanisms and potential therapeutic approaches. Front Physiol. 2018;9:973.
Lokki AI, Heikkinen-Eloranta JK, Laivuori H. The immunogenetic conundrum of preeclampsia. Front Immunol. 2018;9:2630.
Simard JF, Arkema EV, Nguyen C, et al. Early-onset preclampsia in lupus pregnancy. Paediatr Perinat Epidemiol. 2017;31:29-36.
Geldenhuys J, Rossouw TM, Lombaard HA, Ehlers MM, Kock MM. Disruption in the regulation of immune responses in the placental subtype of preeclampsia. Front Immunol. 2018;9:1659.
Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15:275-289.
Valencia-Ortega J, Zárate A, Saucedo R, Hernández-Valencia M, Cruz JG, Puello E. Placental proinflammatory state and maternal endothelial dysfunction in preeclampsia. Gynecol Obstet Invest. 2019;84:12-19.
Mayer-Pickel K, Stern C, Eberhard K, Lang U, Obermayer-Pietsch B, Cervar-Zivkovic M. Angiogenic factors in pregnancies of women with antiphospholipid syndrome and systemic lupus erythematosus. J Reprod Immunol. 2018;127:19-23.
Leaños-Miranda A, Campos-Galicia I, Berumen-Lechuga MG, et al. Circulating angiogenic factors and the risk of preeclampsia in systemic lupus erythematosus pregnancies. J Rheumatol. 2015;42:1141-1149.
Andrade D, Kim M, Blanco LP, et al. Interferon-α and angiogenic dysregulation in pregnant lupus patients who develop preeclampsia. Arthritis Rheumatol. 2015;67:977-987.
Saavedra MA, Sánchez A, Morales S, Navarro-Zarza JE, Ángeles U, Jara LJ. Primigravida is associated with flare in women with systemic lupus erythematosus. Lupus. 2015;24:180-185.
Larosa M, Del Ross T, Calligaro A, et al. Clinical outcomes and predictors of maternal and fetal complications in pregnancies of patients with systemic lupus erythematosus. Exp Rev Clin Immunol. 2019;15(6):617-627.
Imbasciati E, Tincani A, Gregorini G, et al. Pregnancy in women with pre-existing lupus nephritis: predictors of fetal and maternal outcome. Nephrol Dial Transplant. 2009;24:519-525.
Rodríguez-Almaraz ME, Herraiz I, Gómez-Arriaga PI, et al. The role of angiogenic biomarkers and uterine artery Doppler in pregnant women with systemic lupus erythematosus or antiphospholipid syndrome. Pregnancy Hypertens. 2018;11:99-104.
Shanmugalingam R, Hennessy A, Makris A. Aspirin in the prevention of preeclampsia: the conundrum of how, who and when. J Hum Hypertens. 2019;33:1-9.
Schramm AM, Clowse ME. Aspirin for prevention of preeclampsia in lupus pregnancy. Autoimmune Dis. 2014;2014:920467.
Mendel A, Bernatsky SB, Hanly JG, et al. Low aspirin use and high prevalence of pre-eclampsia risk factors among pregnant women in a multinational SLE inception cohort. Ann Rheum Dis Dec. 2018;20:pii: annrheumdis-2018-214434.
Saavedra Salinas MÁ, Barrera Cruz A, Cabral Castañeda AR, et al. Mexican College of Rheumatology practical guidelines for the care of pregnant patients with autoinmune rheumatic diseases. Part 2. Reumatol Clin. 2015;11:295-304.
Rambaldi MP, Weiner E, Mecacci F, Bar J, Petraglia F. Immunomodulation and preeclampsia. Best Pract Res Clin Obstet Gynaecol. 2019;6934(19):87-96.
Wang X, Gao H. Prevention of preeclampsia in high-risk patients with low-molecular-weight heparin: a meta-analysis. J Mater Fetal Neonat Med. 2018;20:1-7.
Kaplan YC, Ozsarfati J, Nickel C, Koren G. Reproductive outcomes following hydroxychloroquine use for autoimmune diseases: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016;81:835-848.
Bermas BL, Kim SC, Huybrechts K, et al. Trends in use of hydroxychloroquine during pregnancy in systemic lupus erythematosus patients from 2001 to 2015. Lupus. 2018;27(6):1012-1017.
Clowse ME, Magder L, Witter F, Petri M. Hydroxychloroquine in lupus pregnancy. Arthritis Rheum. 2006;54:3640-3647.
Koh JH, Ko HS, Kwok SK, Ju JH, Park SH. Hydroxychloroquine and pregnancy on lupus flares in Korean patients with systemic lupus erythematosus. Lupus. 2015;24:210-217.
Eudy AM, Siega-Riz AM, Engel SM, et al. Effect of pregnancy on disease flares in patients with systemic lupus erythematosus. Ann Rheum Dis. 2018;77:855-860.
Leroux M, Desveaux C, Parcevaux M, et al. Impact of hydroxychloroquine on preterm delivery and intrauterine growth restriction in pregnant women with systemic lupus erythematosus: a descriptive cohort study. Lupus. 2015;24:1384-1391.
Mekinian A, Lazzaroni MG, Kuzenko A, et al. The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome: data from a European multicenter retrospective study. Autoimmun Rev. 2015;14:498-502.
Sciascia S, Hunt BJ, Talavera-Garcia E, Lliso G, Khamashta MA, Cuadrado MJ. The impact of hydroxychloroquine treatment on pregnancy outcome in women with antiphospholipid antibodies. Am J Obstet Gynecol. 2016;214:273.e1-273.e8.
Levy RA, Vilela VS, Cataldo MJ, et al. Hydroxychloroquine (HCQ) in lupus pregnancy: double-blind and placebo-controlled study. Lupus. 2001;10:401-404.
Tedeschi SK, Massarotti E, Guan H, Fine A, Bermas BL, Costenbader KH. Specific systemic lupus erythematosus disease manifestations in the six months prior to conception are associated with similar disease manifestations during pregnancy. Lupus. 2015;12:1283-1292.
Kroese SJ, de Hair MJH, Limper M, et al. Hydroxychloroquine use in lupus patients during pregnancy is associated with longer pregnancy duration in preterm births. J Immunol Res. 2017;2017:2810202.
Zhan Z, Yang Y, Zhan Y, Chen D, Liang L, Yang X. Fetal outcomes and associated factors of adverse outcomes of pregnancy in southern Chinese women with systemic lupus erythematosus. PLoS ONE. 2017;12:e0176457.
Khan A, Thomas M, P K SD. Pregnancy complicated by systemic lupus erythematosus and its outcome over 10 years. J Obstet Gynaecol. 2018;38:476-481.
Zusman EZ, Sayre EC, Aviña-Zubieta JA, De Vera MA. Patterns of medication use before, during and after pregnancy in women with systemic lupus erythematosus: a population-based cohort study. Lupus. 2019;28(10):1205-1213.
Abd Rahman R, DeKoninck P, Murthi P, Wallace EM. Treatment of preclampsia with hydroxychloroquine: a review. J Matern Fetal Neonatal Med. 2018;31:525-529.
Saavedra MA, Romo-Rodríguez R, Gutiérrez-Ureña SR, Miranda-Hernández D, Hernández-Cruz LI, Jara LJ. Targeted drugs in spondyloarthritis during pregnancy and lactation. Pharmacol Res. 2018;136:21-28.
Rahman R, Murthi P, Singh H, et al. The effects of hydroxychloroquine on endothelial dysfunction. Pregnancy Hypertens. 2016;6:259-262.
An N, Chen Y, Wang C, et al. Chloroquine autophagic inhibition rebalances Th17/Treg-mediated immunity and ameliorates systemic lupus erythematosus. Cell Physiol Biochem. 2017;44:412-422.
Sacre K, Criswell LA, McCune JM. Hydroxychloroquine is associated with impaired interferon-alpha and tumor necrosis factor-alpha production by plasmacytoid dendritic cells in systemic lupus erythematosus. Arthritis Res Ther. 2012;14:R155.
Liu J, Zhao Y, Song Y, et al. Pregnancy in women with systemic lupus erythematosus: a retrospective study of 111 pregnancies in Chinese women. J Matern Fetal Neonatal Med. 2012;25:261-266.
Rainsford KD, Parke AL, Clifford-Rashotte M, Kean WF. Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases. Inflammopharmacology. 2015;23:231-269.
Plantone D, Koudriavtseva T. Current and future use of chloroquine and hydroxychloroquine in infectious, immune, neoplastic, and neurological diseases: a mini-review. Clin Drug Investig. 2018;38:653-671.
Balevic SJ, Cohen-Wolkowiez M, Eudy AM, Green TP, Schanberg LE, Clowse MEB. Hydroxychloroquine levels throughout pregnancies complicated by rheumatic disease: implications for maternal and neonatal outcomes. J Rheumatol. 2019;46:57-63.