Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy: A meta-analysis of studies published between years 2001–2016

Bundhun, Pravesh Kumar; Soogund, Mohammad Zafooruddin Sani; Huang, Feng

doi:10.1016/j.jaut.2017.02.009

Cited by 187 publications

(169 citation statements)

References 30 publications

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“…Thirdly, residual unknown confounders are always a concern in observational studies. Previous studies reported maternal diabetes or chronic immune diseases are risk factors for congenital malformation or heart malformation . However, these patients have more frequent vaginal fungal infection compared with the general population and therefore those factors could be considered potential risk factors.…”

Section: Discussionmentioning

confidence: 96%

The safety of oral fluconazole during the first trimester of pregnancy: a systematic review and meta‐analysis

Zhang

Zhou

et al. 2019

BJOG

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Background Oral fluconazole is used to treat vulvovaginal candidiasis during pregnancy. However, there are concerns regarding the pregnancy outcomes following exposure to fluconazole.Objectives To evaluate the pregnancy outcomes associated with exposure to oral fluconazole during the first trimester of pregnancy.Search strategy A systematic literature search was conducted to identify relevant studies published from inception until April 2019.Selection criteria Relevant English-language citations using the terms oral fluconazole and pregnancy in humans.Data collection Two reviewers independently abstracted data and assessed study quality.Main results Oral fluconazole use during the first trimester of pregnancy was marginally associated with an increased risk of congenital malformations (odds ratio [OR] 1.09, 95% CI 0.99-1.2, P = 0.088; n = 6 studies), whereas in the subgroup analysis, this association existed only for high-dose users (>150 mg) (OR 1. 19, 95% CI 1.01-1.4, P = 0.039; n = 2). Exposure to fluconazole also increased the risk of heart malformations (OR 1.31, 95% CI 1.09-1.57, P = 0.003; n = 4), cardiac septal defects (OR 1.3, 95% CI 1.1-1.67, P = 0.047; n = 3), and tetralogy of Fallot (OR 3.39 95% CI 1.71-6.74, P < 0.001; n = 2) in the offspring. In addition, exposure to fluconazole was significantly associated with an increased risk of spontaneous abortion (OR 1.99, 95% CI 1.38-2.88, P < 0.001; n = 3).Conclusions Oral fluconazole use during the first trimester of pregnancy appears to be associated with heart malformations and spontaneous abortion, but a causal link cannot be proven.Tweetable abstract Oral fluconazole during the first trimester of pregnancy may be associated with unfavourable pregnancy outcomes.

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Section: Discussionmentioning

confidence: 96%

The safety of oral fluconazole during the first trimester of pregnancy: a systematic review and meta‐analysis

Zhang

Zhou

et al. 2019

BJOG

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“…Actually, this evaluation should be limited to antiphospholipid antibodies (APL) and lupus anticoagulant testings, as there is no clear evidence of the impact of inherited thrombophilia on pregnancy loss, as well as of the efficacy of anticoagulants in these situations [7]. Along with APL, antinuclear antibody (ANA) testing is also recommended, combined with a thorough maternal clinical evaluation, given the association between systemic lupus erythematosus (SLE) and IUFD [8]. Moreover, the search for antiphospholipid antibodies syndrome or other autoimmune disorders may be of great interest with possible far reaching consequences:…”

Section: Elucidating In Utero Fetal Demise: Time To Reassemble the Pimentioning

confidence: 99%

Elucidating in utero fetal demise: time to reassemble the pieces of the puzzle?

Belhomme

Lescoat

Ballerie

et al. 2019

The Journal of Maternal-Fetal & Neonatal Medicine

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“…At 38 Weeks gestation due to large for date fetus, although she had normal GTT, an elective LSCS was done and she delivered a live male baby weighing 4kg with normal apgar score 8, 10 with fetus remaining normal neonatal. 5 Successful pregnancy outcomes following use of enoxaparin in recurrent pregnancy loss without apl antibodies-report of 2 cases 66…”

Section: Casementioning

confidence: 99%

Successful pregnancy outcomes following use of enoxaparin in recurrent pregnancy loss without apl antibodies-report of 2 cases

Kaur¹,

Allahbadia²,

Singh³

2017

IJFCM

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Recurrent Pregnancy losses are defined as pregnancy losses up to 20 weeks of gestation age. Most causes are thrombophilias of which positive Antiphospholipid antibodies are the commoners, others being hereditary thrombophilias, uterine defects, infections, endocrine disorders like DM, thyroid disorders, hyperprolactinemia etc. Usually the treatment that is offered is empirical like progesterone, dydrogesterone, IV immune globulins, and intralipids and in thrombophilias due to positive APL antibodies Enoxaparin and low dose aspirins recommended but not as a routine.Here we report 2 cases of RPL where there was no APL anybody positivity but early Enoxaparin was started till 33 weeks and we got a positive result in the form of live fetus born at 37 plus weeks in both cases.

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Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy: A meta-analysis of studies published between years 2001–2016

Cited by 187 publications

References 30 publications

The safety of oral fluconazole during the first trimester of pregnancy: a systematic review and meta‐analysis

The safety of oral fluconazole during the first trimester of pregnancy: a systematic review and meta‐analysis

Elucidating in utero fetal demise: time to reassemble the pieces of the puzzle?

Successful pregnancy outcomes following use of enoxaparin in recurrent pregnancy loss without apl antibodies-report of 2 cases

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