Pregnancy in Women with Systemic Lupus Erythematosus:  A Retrospective Study of 83 Pregnancies at a Single Centre

Chen, Shanying; Sun, Xiaoduan; Wu, Bin; Lian, Xuejian

doi:10.3390/ijerph120809876

Cited by 29 publications

(25 citation statements)

References 31 publications

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“…Pregnancy may increase SLE activity, and have short or long-term adverse effects on renal function, while SLE can result in adverse pregnancy outcomes and complications such as preeclampsia, preterm delivery, and fetal loss. 2 In past decades, SLE was a contraindication for pregnancy. However, with improvements in treatment and multidisciplinary management, the success rate of delivery in women with SLE has greatly improved.…”

Section: Introductionmentioning

confidence: 99%

Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Wu¹,

Ma²,

Zhang³

et al. 2018

TCRM

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BackgroundAlthough it is well established that systemic lupus erythematosus (SLE) negatively affects pregnancy outcomes, there is insufficient evidence on the effect of lupus nephritis (LN) on antenatal management and pregnancy outcomes. We performed a systematic review and meta-analysis to determine the association of LN with management and pregnancy outcomes in SLE patients.MethodsEmbase, Medline, Cochrane, and ClinicalTrials.gov were carefully searched for relevant English and Chinese language studies. A total of 2,987 articles were reviewed. Data were extracted that compared management and pregnancy outcomes in SLE pregnant women with LN vs without LN. Risk of bias was assessed by a modified version of the Newcastle-Ottawa Scale and the STROBE checklist. Combined odds ratios (OR) and 95% confidence intervals (CI) were obtained and sensitivity analysis was performed using RevMan 5.3 software.ResultsSixteen studies, including 1,760 pregnant patients with SLE, were included. Gestational hypertension (OR=5.65, 95% CI=2.94–10.84), preeclampsia (OR=2.84, 95% CI=1.87–4.30), SLE flare (OR=2.66, 95% CI=1.51–4.70), renal flare (OR=15.18, 95% CI=5.89–39.14), proteinuria (OR=8.86, 95% CI=4.75–16.52), and hypocomplementemia (OR=2.86, 95% CI=1.68–4.87) were significantly affected in pregnant women with LN. Anti-Sjögren’s syndrome-related antigen A/Ro autoantibodies were negatively associated with pregnant women with LN (OR=0.57, 95% CI=0.33–0.98). Pregnant women with LN presented a significant decrease in live births (OR=0.62, 95% CI=0.49–0.80) and a significant increase in preterm births (OR=1.92, 95% CI=1.49–2.49) and fetal growth restriction (OR=1.43, 95% CI=1.08–1.91). Regarding antenatal management, steroids (OR=2.48, 95% CI=1.59–3.87) and immunosuppressant treatment (OR=6.77, 95% CI=3.30–13.89) were more frequently used in women with LN.ConclusionThis review identified a significant association between the aforementioned outcomes and SLE pregnant patients with LN. In patients with SLE, LN increased the risks for adverse pregnancy outcomes and the use of medication. Therefore, special treatment and close monitoring should be allocated to pregnant women with LN.

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Section: Introductionmentioning

confidence: 99%

Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Wu¹,

Ma²,

Zhang³

et al. 2018

TCRM

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“…Studies also suggest that the outcomes of lupus pregnancies are better if pregnancy is delayed until the disease is in a quiescent state for at least 6 months. 5 Also the medication adjusted in advance has the advantage of enduring pregnancy till term with a positive outcome. 3 Though preconceptional counseling has a vital role; none of the patients seek for it.…”

Section: Discussionmentioning

confidence: 99%

Systemic Lupus Erythematosus and Pregnancy Outcome in Tertiary Level Hospital of Nepal

2019

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Introduction: Systemic Lupus Erythematosus is an autoimmune disease frequently prevalent in women starting from early childhood and towards the reproductive age. Pregnancy with SLE has always imposed great risk both to the mother and the fetus. A multidisciplinary approach with Nephrologist, neonatologist and senior obstetrician during remission leads to a favorable response, through limitation and complications with the use of drugs impose difficulties in their management.Materials and Methods: A prospective, descriptive study was conducted in the Department of Obstetrics and Gynecology and Nephrology at Tribhuvan University Teaching Hospital, for 2 years, from June 2015 to 2017. The study included obstetrical and related complications with outcome in pregnant patients with Systemic Lupus Erythematosus.Results: A total of 19 cases were analyzed of which 15 (79%) had a viable pregnancy and 4 (21%) abortions. Of thirteen cases, 4 (21%) had antiphospholipid antibody syndrome, 8 (42.1%) lupus, and membranous glomerulonephritis and 1 (5.2%) lupus optic neuropathy with loss of vision. All the patients were under drug therapy, like prednisolone, azathioprine, hydroxychloroquine, aspirin, low molecular weight Heparin, tacrolimus, and cyclophosphamide. Only 2 (10.5%) of 19 developed severe pre-eclampsia. There were 12 (80%) term and 3 (20%) each of preterm and intrauterine growth retardation pregnancies with 1 (6.6%) neonatal death (NND) and 1 (5.2%) maternal mortality.Conclusions: Multidisciplinary approach and planned pregnancy reduces the risk of probable complications in the patient resulting to a decreased morbidity and mortality.

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“…The findings allow to demonstrate the usefulness of ultrasonography in patients with a history of recurrent urinary tract infections; and to monitor renal health of these patients during pregnancy, to identify the cause predisposing to infection may be silent. 29,30 A high frequency of hypertension (15 patients) was also recorded, to which added 6 pregnant women with hypertensive disorders are associated with pregnancy. And 5 patients with Diabetes Mellitus, in which attention is not confined to pregnancy, but beyond, to offer alternatives and avoid severe health complications later in life.…”

Section: Discussionmentioning

confidence: 99%

Renal ultrasound: analysis and use in pregnant

Velasco¹,

Rivera²,

Cabrera³

et al. 2018

IPCB

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Biometrics renal standardizes in the gestating without pathology because there are no local measurements with these parameters during pregnancy in the country. The presence of renal disorders in pregnant women with medical conditions associated is evaluated. A descriptive, prospective and correlational study review. The sample is non-probabilistic type and intentional selection consisting of 198 pregnant patients, consisting of those who attended the consultation ultrasound of Maternal Fetal Medicine Maternity "Concepcion Palacios", which were distributed in a group of 149 pregnant women had no medical pathologies associated, and a B group of 49 pregnant women if presented. A table of percentiles for renal biometry pregnant was developed by gestational age. Ages ranged from 24.2±6, 2 years and 26.2±7.1 years for groups A and B, respectively. Primigestas predominated with 36.2% in group A and 42.8% in the group B. percentiles are calculated and the corresponding tables of renal diameters pregnant were prepared by gestational age. The sonographic findings reveal that diameters of renal morphology in pregnant women without renal disease in each of the trimesters of pregnancy.

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Pregnancy in Women with Systemic Lupus Erythematosus: A Retrospective Study of 83 Pregnancies at a Single Centre

Cited by 29 publications

References 31 publications

Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Systemic Lupus Erythematosus and Pregnancy Outcome in Tertiary Level Hospital of Nepal

Renal ultrasound: analysis and use in pregnant

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