Acevedo Magdalena, Pretini Julia, Micelli Marina, Sequeira Gabriel, Kerzberg Eduardo
Servicio de Reumatología, Hospital J. M. Ramos Mejía, Urquiza 609, (ZIP 1221), Ciudad Autónoma de Buenos Aires, Argentina.
Rheumatol Int. 2017 Jul;37(7):1183-1186. doi: 10.1007/s00296-017-3750-1. Epub 2017 May 24.
To assess breastfeeding in patients with systemic lupus erythematosus (SLE), a cross-sectional study of patients with SLE compared to a non-SLE sample was performed. Patients who had pregnancies subsequent to their diagnosis of SLE and who were followed up in the hospital were interviewed. The group of non-SLE mothers consisted of patients who had no known rheumatic disease at the time of their pregnancy, and who were approached at the hospital paediatrics service waiting room. Thirty-six pregnancies in 31 patients with SLE and the same number of non-SLE mothers were studied. The number of SLE patients who did not initiate breastfeeding was higher than that of non-SLE mothers (19.4 vs 5.6%, respectively; p 0.07). The average duration of breastfeeding in SLE patients was 6 months (SD 6 months) versus 12 months (SD 8 months) in non-SLE mothers (log rank p: 0.003). Fifty-three percent of the non-SLE mothers indicated no particular reason for weaning, and considered that they had nursed their children a suitable amount of time. Conversely, SLE patients often set weaning in motion on the grounds that they had been placed on medication (41%). However, when the treatment was analysed, in 6 out of 12 cases, it consisted of low doses of either corticosteroids or hydroxychloroquine. Patients with SLE showed reduced rates of initiating breastfeeding. They also showed reduced duration of breastfeeding, and the reason for cessation was frequently cited to be therapies which were actually of low risk. Breastfeeding duration could be optimised by improving the level of information provided to patients.
为评估系统性红斑狼疮（SLE）患者的母乳喂养情况，开展了一项横断面研究，将SLE患者与非SLE样本进行比较。对确诊SLE后怀孕并在医院接受随访的患者进行了访谈。非SLE母亲组由怀孕时无已知风湿性疾病且在医院儿科服务候诊室被招募的患者组成。研究了31例SLE患者的36次妊娠以及相同数量的非SLE母亲。未开始母乳喂养的SLE患者数量高于非SLE母亲（分别为19.4%和5.6%；p = 0.07）。SLE患者的平均母乳喂养持续时间为6个月（标准差6个月），而非SLE母亲为12个月（标准差8个月）（对数秩检验p值：0.003）。53%的非SLE母亲表示断奶没有特别原因，并认为她们已对孩子进行了适当时间的哺乳。相反，SLE患者常因正在服药而开始断奶（41%）。然而，分析治疗情况时，12例中有6例使用的是低剂量的皮质类固醇或羟氯喹。SLE患者开始母乳喂养的比例较低。他们的母乳喂养持续时间也较短，且断奶原因常被认为是实际风险较低的治疗。通过提高向患者提供的信息水平，可以优化母乳喂养持续时间。
