Ramsey-Goldman R, Kutzer J E, Kuller L H, Guzick D, Carpenter A B, Medsger T A
Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pennsylvania.
Am J Reprod Immunol. 1992 Oct-Dec;28(3-4):195-8. doi: 10.1111/j.1600-0897.1992.tb00790.x.
Women with systemic lupus erythematosus (SLE) have increased adverse pregnancy outcomes. The reasons for these problems include maternal disease, clinical or serologic activity, medication use, and residual organ impairment from prior disease flares. In retrospective studies, pregnancy data are often treated cross-sectionally, with births rather than mothers as the unit of analysis. Multiple pregnancies from the same mother may be highly correlated with each other. In an unmatched retrospective study, the first two pregnancy outcomes in lupus patients with anticardiolipin antibody (anti-CL IgG or IgM isotype) (cases N = 47) and without anticardiolipin antibody (controls, N = 125) were assessed according to birth order. A good outcome was defined as a full-term (> 38 weeks) live birth without neonatal complications. All other pregnancy outcomes were considered adverse outcomes. Therapeutic abortions and ectopic or molar pregnancies were excluded. Both cases and controls with an adverse outcome in their first pregnancy had at least a 50% chance of another adverse outcome in their second pregnancy. Cases with a late miscarriage (fetal loss at 14 to 20 weeks' gestation) in their first pregnancy had the highest risk, 80%, of an adverse outcome in their second pregnancy. Both previous pregnancy loss and anti-CL antibody status should be considered in the analysis of pregnancy outcomes in women with SLE.
系统性红斑狼疮（SLE）女性的不良妊娠结局有所增加。这些问题的原因包括母体疾病、临床或血清学活动、药物使用以及既往疾病发作导致的残留器官损害。在回顾性研究中，妊娠数据通常按横断面处理，以出生而非母亲作为分析单位。同一母亲的多次妊娠可能彼此高度相关。在一项非配对回顾性研究中，根据出生顺序评估了抗心磷脂抗体（抗CL IgG或IgM亚型）的狼疮患者（病例组N = 47）和无抗心磷脂抗体的患者（对照组，N = 125）的前两次妊娠结局。良好结局定义为足月（> 38周）活产且无新生儿并发症。所有其他妊娠结局均被视为不良结局。治疗性流产、异位妊娠或葡萄胎妊娠被排除在外。首次妊娠结局不良的病例组和对照组在第二次妊娠时再次出现不良结局的几率至少为50%。首次妊娠发生晚期流产（妊娠14至20周胎儿丢失）的病例组在第二次妊娠时出现不良结局的风险最高，为80%。在分析SLE女性的妊娠结局时，应同时考虑既往妊娠丢失和抗CL抗体状态。
