Wong K L, Chan F Y, Lee C P
Department of Medicine, Queen Mary Hospital, Hong Kong, China.
Arch Intern Med. 1991 Feb;151(2):269-73.
A prospective study was performed to investigate the outcome and complications of pregnancy in patients with systemic lupus erythematosus. Twenty-nine pregnancies occurred in 22 patients. There were 12 abortions, two spontaneous and 10 induced. Fifteen women had 17 live-born neonates. Neonatal complications included nine premature deliveries, two cases of intrauterine growth retardation, and one of Treacher Collins syndrome. Obstetric complications included threatened abortion (two), placenta previa (two), and preeclampsia (three). Cesarean sections were necessary in five patients. There was no maternal or neonatal mortality. Thirteen episodes of systemic lupus erythematosus relapses were detected by incidents of increasing proteinuria (six), arthritis (four), and vasculitic rash (two). There were no statistical differences in changes in hemoglobin level, erythrocyte sedimentation rate, albumin level, antinuclear antibody titer, or C3 or C4 level between the patients who relapsed and those who did not. Pregnancy could induce a flare of systemic lupus erythematosus in previously normal patients or patients with previously inactive disease. The overall neonatal and maternal survival was good, even in patients who presented during pregnancy. Spontaneous fetal loss was low (2/29 [6.9%]); both cases occurred in mothers with inactive lupus.
一项前瞻性研究旨在调查系统性红斑狼疮患者的妊娠结局及并发症。22例患者共发生29次妊娠。其中有12次流产，2次自然流产，10次人工流产。15名女性产下17名活产新生儿。新生儿并发症包括9例早产、2例宫内生长受限以及1例特雷彻·柯林斯综合征。产科并发症包括先兆流产（2例）、前置胎盘（2例）和子痫前期（3例）。5例患者需要进行剖宫产。无孕产妇或新生儿死亡。通过蛋白尿增加（6例）、关节炎（4例）和血管性皮疹（2例）事件检测到13次系统性红斑狼疮复发。复发患者与未复发患者在血红蛋白水平、红细胞沉降率、白蛋白水平、抗核抗体滴度或C3或C4水平的变化上无统计学差异。妊娠可使既往病情正常或疾病处于非活动期的患者发生系统性红斑狼疮病情活动。即使是在孕期发病的患者中，总体新生儿和孕产妇存活率也良好。自然流产率较低（2/29 [6.9%]）；两例均发生在狼疮病情非活动期的母亲中。
