妊娠期混合性结缔组织病：病例系列及系统文献综述
Mixed connective tissue disease in pregnancy: A case series and systematic literature review.
作者信息
Tardif Marie-Lou, Mahone Michèle
机构信息
Internal Medicine Division, Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.
出版信息
Obstet Med. 2019 Mar;12(1):31-37. doi: 10.1177/1753495X18793484. Epub 2018 Sep 19.
OBJECTIVE
To investigate the impact of medical and obstetric complications associated with mixed connective tissue disease (MCTD) in pregnancy.
METHOD
We analyzed 68 pregnancies from a systematic literature review and 12 pregnancies affected by MCTD at our centre between 1986 and 2015 for medical and obstetric complications.
RESULTS
During pregnancy 37.1% had active MCTD and 26.7% had relapsed. Maternal complications included caesarean section (31.1%, = 19), preeclampsia (17.6%, = 13), thromboembolism events, and death (2.5%, = 2 for each). Fetal complications included prematurity (48.1%, = 25), intrauterine growth restriction (38.3%, = 19), and neonatal lupus (28.6%, = 18, including chondrodysplasia punctata). More than half ( = 10) of the neonatal lupus cases were explained by anti-URNP only. The perinatal mortality rate was 17.7% ( = 14). Pregnant women with active disease had higher rates of prematurity (OR = 7.60; 95%CI [1.93; 29.95]) and perinatal death (OR = 16.83; 95%CI [1.90; 147.70]).
CONCLUSION
MCTD in pregnancy puts women at risk of medical and obstetric complications, and disease activity probably increases this risk.
目的
探讨妊娠合并混合性结缔组织病（MCTD）的医学和产科并发症的影响。
方法
我们对一项系统文献综述中的68例妊娠以及1986年至2015年间在我们中心的12例受MCTD影响的妊娠进行了医学和产科并发症分析。
结果
孕期37.1%的患者患有活动性MCTD，26.7%的患者病情复发。母体并发症包括剖宫产（31.1%，n = 19）、子痫前期（17.6%，n = 13）、血栓栓塞事件和死亡（各2.5%，n = 2）。胎儿并发症包括早产（48.1%，n = 25）、宫内生长受限（38.3%，n = 19）和新生儿狼疮（28.6%，n = 18，包括点状软骨发育不良）。超过一半（n = 10）的新生儿狼疮病例仅由抗U1RNP抗体解释。围产儿死亡率为17.7%（n = 14）。患有活动性疾病的孕妇早产率（OR = 7.60；95%CI [1.93；29.95]）和围产儿死亡率（OR = 16.83；95%CI [1.90；147.70]）更高。
结论
妊娠合并MCTD使女性面临医学和产科并发症的风险，疾病活动可能会增加这种风险。
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