Impact of low-dose acetylsalicylic acid on pregnancy outcome in systemic lupus erythematosus: results from a multicentre study.
lupus erythematosus, systemic
outcome assessment, health care
therapeutics
Journal
Lupus science & medicine
ISSN: 2053-8790
Titre abrégé: Lupus Sci Med
Pays: England
ID NLM: 101633705
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
15
04
2022
accepted:
02
06
2022
entrez:
14
6
2022
pubmed:
15
6
2022
medline:
18
6
2022
Statut:
ppublish
Résumé
It is still a matter of debate whether low-dose acetylsalicylic acid (LDASA) should be prescribed to all patients with SLE during pregnancy. This study aimed at investigating the impact of LDASA on pregnancy outcomes in patients with SLE without history of renal involvement and without antiphospholipid antibodies (aPL). This is a retrospective analysis of prospectively monitored pregnancies at seven rheumatology centres. Previous/current renal involvement and aPL positivity were the exclusion criteria. Adverse pregnancy outcome (APO) is the composite outcome of the study and included proteinuric pre-eclampsia, preterm delivery <37 weeks, small-for-gestational age infant, low birth weight <2500 g, intrauterine growth restriction and intrauterine fetal death after 12 weeks of gestation of a morphologically normal fetus. 216 pregnancies in 187 patients were included; 82 pregnancies (38.0%) were exposed to LDASA treatment. No differences in terms of age at conception, disease duration, clinical manifestations, comorbidities and disease flare during pregnancy were observed between patients taking LDASA and those who did not take LDASA during pregnancy. APO was observed in 65 cases (30.1%), including 13 cases (6.1%) of pre-eclampsia. The incidence of all complications was similar in the two groups. However, it is interesting to note that pre-eclampsia had lower frequency in patients taking LDASA versus those not taking LDASA (2.4% vs 8.3%, p=0.14). In pregnant patients with SLE without renal involvement and were aPL-negative, there is a low risk of severe obstetric complications, such as early pre-eclampsia. LDASA treatment does not provide a statistically significant advantage over these complications. However, a careful individual risk-benefit balance is warranted.
Identifiants
pubmed: 35701044
pii: 9/1/e000714
doi: 10.1136/lupus-2022-000714
pmc: PMC9198794
pii:
doi:
Substances chimiques
Aspirin
R16CO5Y76E
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Lupus. 2004;13(11):857-60
pubmed: 15580982
N Engl J Med. 2017 Aug 17;377(7):613-622
pubmed: 28657417
Medicine (Baltimore). 2020 Apr;99(16):e19797
pubmed: 32311994
Clin J Am Soc Nephrol. 2010 Nov;5(11):2060-8
pubmed: 20688887
Arthritis Rheum. 1997 Sep;40(9):1725
pubmed: 9324032
Am J Perinatol. 2012 Aug;29(7):551-6
pubmed: 22495898
Obstet Gynecol. 2013 Nov;122(5):1122-1131
pubmed: 24150027
Ann Intern Med. 2014 Dec 2;161(11):819-26
pubmed: 25200125
Am J Obstet Gynecol. 2008 Aug;199(2):127.e1-6
pubmed: 18456233
Arthritis Care Res (Hoboken). 2020 Apr;72(4):461-488
pubmed: 32090466
Ann Intern Med. 2015 Aug 4;163(3):153-63
pubmed: 26098843
Eur J Obstet Gynecol Reprod Biol. 2013 Sep;170(1):1-7
pubmed: 23746796
Ann Rheum Dis. 2019 Jul;78(7):1010-1012
pubmed: 30573656
Psychometrika. 2013 Oct;78(4):685-709
pubmed: 24092484
Maedica (Bucur). 2019 Jun;14(2):148-160
pubmed: 31523297
Lupus. 2018 Sep;27(10):1679-1686
pubmed: 30016929
Eur J Obstet Gynecol Reprod Biol. 2020 May;248:156-163
pubmed: 32217429
Ann Rheum Dis. 2017 Mar;76(3):476-485
pubmed: 27457513
Obstet Gynecol. 2018 Jul;132(1):e44-e52
pubmed: 29939940
Rheumatology (Oxford). 2021 Dec 1;60(12):5610-5619
pubmed: 33590843
Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004659
pubmed: 17443552