Lupus and Pregnancy—15 Years of Experience in a Tertiary Center

Ambrósio, Paula; Lermann, Rita; Cordeiro, Alexandra; Borges, Augusta; Nogueira, Isabel; Serrano, Fátima

doi:10.1007/s12016-009-8139-9

Cited by 33 publications

(26 citation statements)

References 22 publications

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“…In the PROMISSE study, patients with important comorbidity, for example, patients with diabetes mellitus or urinary protein–creatinine ratio greater than 1000 mg/g and patients using medium or high dosages of glucocorticoids were excluded. The preterm birth rate < 37 weeks found in our study is in line with the results of other studies [12, 39, 40]. …”

Section: Discussionsupporting

confidence: 94%

Maternal and Perinatal Outcome in Women with Systemic Lupus Erythematosus: A Retrospective Bicenter Cohort Study

Kroese

Abheiden

Blomjous

et al. 2017

Journal of Immunology Research

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Objective To investigate disease activity around and during pregnancy and pregnancy outcome in women with systemic lupus erythematosus (SLE) considering antiphospholipid antibody status. Moreover, differences between first and consecutive pregnancies were examined. Methods Pregnancies > 16 weeks gestation of SLE patients receiving joint care from rheumatologists and gynecologists in two tertiary centers in the Netherlands between 2000 and 2015 were included. Disease activity, flare rate, and pregnancy outcomes and complications were assessed. Results Ninety-six women (84% Caucasian) with 144 pregnancies were included. The median SLE(P)DAI score was 2 before, during, and after pregnancy. Flare rates were 6.3%, 20.1%, and 15.3%, respectively. Severe hypertensive disorder of pregnancy, intrauterine fetal death, preterm birth, and small-for-gestational age infants occurred in 18.1%, 4.1%, 32.7%, and 14.8%, respectively. Complication rates were similar in the first and consecutive pregnancies. Half of the women did not experience any pregnancy complication whereas 42.7% developed a complication during all pregnancies. Mean number of pregnancies was 2.4 and live births 1.7. Conclusion In this SLE population with low disease activity, pregnancy complications were present irrespective of antiphospholipid antibody status. Furthermore, there were no differences in complication rates between the first and consecutive pregnancies as seen in healthy mothers. This information is useful for patient counseling.

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Section: Discussionsupporting

confidence: 94%

Maternal and Perinatal Outcome in Women with Systemic Lupus Erythematosus: A Retrospective Bicenter Cohort Study

Kroese

Abheiden

Blomjous

et al. 2017

Journal of Immunology Research

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“…The adverse outcome was apparently restricted to patients with APS/SLE. An unsatisfactory outcome of pregnancies in these patients has been reported by other groups [11,30,34]. The reasons for such poor outcomes are still unknown.…”

Section: Discussionmentioning

confidence: 78%

“…APS occurs isolated (primary APS or PAPS) or in association with a systemic autoimmune disease [APS/rheumatic disease (RD)], in particular SLE (APS/SLE). APS/SLE have a worse pregnancy outcome than patients with PAPS and with SLE alone [11]. The diagnosis of APS/SLE is also associated with an increased risk of perinatal death [2].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes in patients with systemic autoimmunity

et al. 2011

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The impact of maternal systemic autoimmune diseases on pregnancy outcome is not unequivocally defined. We analysed the pregnancy outcome of 221 pregnancies from 181 autoimmune patients, consecutively followed in a single Italian reference centre from 2001 to 2009. All patients were prospectively followed with monthly visits. Pregnancy outcome was compared with the previous obstetrical history. The patient population comprised five groups: primary antiphospholipid syndrome (PAPS, 39 pregnancies), antiphospholipid syndrome associated with a rheumatic disease (APS/RD, 17 pregnancies), other RD (92 pregnancies), isolated autoantibodies (autoAbs) in the absence of a definite autoimmune disease (aAbs, 38 pregnancies) and reactive arthritis or spondyloarthropathies (35 pregnancies). Of these patients, 50.6% had previous pregnancy complications with an anamnestic live-birth rate of 43.4%. In these patients, complications dropped to 28.2% (44/156). This percentage was very similar to that observed in the 221 pregnancies (29.9%, 66/221) with a live-birth rate of 87.3%. Mean neonatal weight was 3018 ± 611 g; mean gestational age at delivery was 38.17 ± 2.79 weeks. Thus, 10.4% of pregnancies resulted in preterm delivery and 10.9% newborns had low weight at delivery. APS/RD patients had the worse outcome: 17.6% resulted in miscarriage, 14.3% resulted in growth restriction and 50% resulted in preterm delivery. This result was mainly due to patients with APS/systemic lupus erythematosus (SLE) that had the lowest gestational age at delivery (30.8 ± 3.56 weeks) and the lowest newborn weight (1499 ± 931 g). Results confirm that a strict follow-up and targeted treatments significantly improve pregnancy outcomes in autoimmune patients with PAPS, SLE and isolated autoAbs. The pregnancy outcome in patients with APS/SLE remains unsatisfactory.

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“…complications (19,20). However, in both studies all patients with SLE and aPL used LMWH, in absence of a control group without LMWH use.…”

Section: <0001mentioning

confidence: 93%

Low-molecular-weight heparin and aspirin use in relation to pregnancy outcome in women with systemic lupus erythematosus and antiphospholipid syndrome: A cohort study

Abheiden

Blomjous

Kroese

et al. 2016

Hypertension in Pregnancy

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Lupus and Pregnancy—15 Years of Experience in a Tertiary Center

Cited by 33 publications

References 22 publications

Maternal and Perinatal Outcome in Women with Systemic Lupus Erythematosus: A Retrospective Bicenter Cohort Study

Maternal and Perinatal Outcome in Women with Systemic Lupus Erythematosus: A Retrospective Bicenter Cohort Study

Pregnancy outcomes in patients with systemic autoimmunity

Low-molecular-weight heparin and aspirin use in relation to pregnancy outcome in women with systemic lupus erythematosus and antiphospholipid syndrome: A cohort study

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