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阿根廷系统性红斑狼疮(SLE)患者72例妊娠的母婴结局

Maternal and fetal outcomes of 72 pregnancies in Argentine patients with systemic lupus erythematosus (SLE).

作者信息

Cavallasca Javier A, Laborde Hugo A, Ruda-Vega Hilda, Nasswetter Gustavo G

机构信息

Division of Rheumatology, Hospital de Clínicas José de San Martín, School of Medicine, University of Buenos Aires, Avenida Córdoba 2351. 8 degrees Piso, Código Postal 1120 AAF, Buenos Aires, Argentina

出版信息

Clin Rheumatol. 2008 Jan;27(1):41-6. doi: 10.1007/s10067-007-0649-3. Epub 2007 May 22.

Abstract

The purpose of the following study was to analyze maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE) and the influence of SLE exacerbations on those pregnancies. Seventy-two pregnancies in 61 SLE patients treated between January 1986 and February 2004 in Hospital de Clínicas "José de San Martin" were reviewed retrospectively. Patient age was 28.1 +/- 6.2 years (mean+/-standard deviation [SD]). Mean SLE duration was 4.5 +/- 3.2 years (range 6 months-10 years). No patient acquired the disorder during gestation. Four (5.5%) patients had signs of active disease at the beginning of her pregnancy. Sixteen patients, accounting for 20 pregnancies, had a history of lupus nephritis. Nine patients met secondary antiphospholipid syndrome criteria and had 13 pregnancies. There were 14 exacerbations of the disease during pregnancy (19.4%), with most flares being mild. The most common obstetric complications were gestational hypertension in 15 pregnancies (20.8%) and preeclampsia in 8 pregnancies (11%). Forty-six percent of pregnancies ended in preterm deliveries. There were 62 live births (1 twin birth; 85%), 6 stillbirths (8%), and 5 spontaneous abortions (7%). Thirty-nine percent of newborns had low birth weight. Adequate pregnancy follow-up and delivery care by an interdisciplinary team in Argentine SLE patients with no pre-gestational preparation resulted in maternal and fetal outcomes similar to those seen in world reference centers.

摘要

以下研究的目的是分析系统性红斑狼疮(SLE)孕妇的母婴结局以及SLE病情加重对这些妊娠的影响。回顾性分析了1986年1月至2004年2月在“何塞·德·圣马丁”临床医院接受治疗的61例SLE患者的72次妊娠情况。患者年龄为28.1±6.2岁(均值±标准差[SD])。SLE平均病程为4.5±3.2年(范围6个月至10年)。无患者在妊娠期患该病。4例(5.5%)患者在妊娠开始时出现疾病活动迹象。16例患者有狼疮性肾炎病史,共20次妊娠。9例患者符合继发性抗磷脂综合征标准,共13次妊娠。妊娠期有14次疾病加重(19.4%),多数病情发作较轻。最常见的产科并发症是15次妊娠(20.8%)出现妊娠期高血压,8次妊娠(11%)出现先兆子痫。46%的妊娠以早产告终。有62例活产(1例双胎分娩;85%),6例死产(8%),5例自然流产(7%)。39%的新生儿出生体重低。在阿根廷,由跨学科团队对未进行孕前准备的SLE患者进行充分的孕期随访和分娩护理,母婴结局与世界参考中心所见相似。

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