Predictors Associated with Adverse Pregnancy Outcomes in a Cohort of Women with Systematic Lupus Erythematosus from Romania—An Observational Study (Stage 2)

Abstract

Background: Pregnancy in women with systemic lupus erythematosus (SLE) is accompanied by adverse pregnancy outcomes (APOs). We aimed to investigate the association between clinical, sonographic, and laboratory parameters and APOs (preeclampsia, intrauterine growth restriction, premature birth, and maternal mortality). Methods: This observational retrospective study included all pregnancies in women with SLE who attended two tertiary maternity hospitals from Romania between January 2013 and December 2020. Clinical, sonographic, and laboratory variables were examined. Bivariate associations of APO status and each predictor variable were evaluated, and significant predictors were further included in a classification model based on discriminant analysis. Results: Predictors of APOs included BMI > 25 kg/m2, personal history of lupus nephritis or chronic hypertension, proteinuria, low C3, SLE Disease Activity Index 2000 (SLEDAI-2k score ≥ 4 and physician’s global-assessment (PGA) score ≥ 1 throughout pregnancy, increased mean uterine arteries pulsatility index in the first and second trimesters, cerebroplacental ratio < 1 in the second and third trimesters, and small fetal abdominal circumference in the third trimester. Glucocorticoids, methyldopa, and aspirin use appeared to be protective against APOs. Conclusions: This study provides a comprehensive analysis of the most important predictors for APOs in pregnant patients with SLE, which could constitute a basis for further research.

Potential genetic biomarkers predict adverse pregnancy outcome during early and mid-pregnancy in women with systemic lupus erythematosus

“…Previous studies ( 5 , 7 – 10 ) had reported multiple predictors of APO in women with SLE. Mankee et al.…”

“…Vicoveanu et al. ( 10 ) determined an SLE Disease Activity Index 2000 (SLEDAI-2k) score greater than or equal to 4 from the first trimester and maternal body mass index to be the top predictors for APO in women with SLE. However, even after intensive research, prediction strategies for the first and second trimester are lacking.…”

Investigating the Association between Serum and Hematological Biomarkers and Neonatal Sepsis in Newborns with Premature Rupture of Membranes: A Retrospective Study

“…Children 2024, 11, 124 2 of 17 or current pregnancy complications that require an iatrogenic preterm birth [5][6][7][8][9][10][11][12][13][14][15]. Previous studies have proven that the lower the gestational age (GA) at which the membranes rupture, the greater the probability of infection [16,17].…”

Unraveling the Efficacy of Therapeutic Interventions for Short Cervix: Insights from a Retrospective Study for Improved Clinical Management

“…Maternal characteristics are the most studied, and it was proven that ethnicity, extremes of maternal age, low maternal education, smoking, illicit drug consumption, personal history of preterm birth, short cervical length (less than 2.5 cm), and maternal comorbidities (vaginal or systemic infections, autoimmune disorders, thrombophilia, etc.) were significantly associated with the occurrence of PTB [ 13 , 14 , 15 , 16 ]. Moreover, some hormonal and vitamin imbalances have been proposed as risk factors for pregnancy complications, such as PTB [ 17 ].…”