Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
Clin Rheumatol. 2020 Feb;39(2):319-325. doi: 10.1007/s10067-019-04823-8. Epub 2019 Nov 21.
The impact of systemic lupus erythematosus (SLE) on preeclampsia is still obscure. This study was performed to systematically assess the association between preeclampsia and SLE.
According to the PRISMA statement, designed literature research was performed in PubMed, Web of Science, and Cochrane Library from inception to June 30, 2018. The pooled risk ratio (RR) of preeclampsia in pregnant SLE patients compared with health controls was synthesized by fixed effect model or random effects model depending on heterogeneity.
Ten studies involving 6,389 SLE patients were included. Pregnant women with SLE have significantly increased risk of preeclampsia (RR = 2.99, 95% CI = 2.31 to 3.88; Z = 8.31, P < 0.001) compared with health controls. Subgroup analysis showed that the risk of preeclampsia was significant (Q = 7.64, P = 0.006) higher in prospective studies (RR = 6.94, 95% CI = 3.59 to 13.42) compared to retrospective studies (RR = 2.60, 95% CI = 2.08 to 3.25).
The present study demonstrated that pregnant SLE patients have a high risk of preeclampsia, suggesting a pivotal role of SLE in the pathogenesis of preeclampsia. For rheumatologists and SLE patients, it is important to maintain inactive disease activity and prevent complications as LN, and the control of traditional risk factors of preeclampsia is also pivotal. Further study focus on the prevention of preeclampsia in SLE is also urgent.
系统性红斑狼疮（SLE）对先兆子痫的影响仍不清楚。本研究旨在系统评估先兆子痫与 SLE 之间的关系。
根据 PRISMA 声明，从建库至 2018 年 6 月 30 日，在 PubMed、Web of Science 和 Cochrane Library 中进行了设计文献检索。采用固定效应模型或随机效应模型，根据异质性，综合分析妊娠 SLE 患者先兆子痫的合并风险比（RR）。
纳入了 10 项研究，共 6389 例 SLE 患者。与健康对照相比，SLE 孕妇先兆子痫的风险显著增加（RR=2.99，95%CI=2.313.88；Z=8.31，P<0.001）。亚组分析显示，前瞻性研究（RR=6.94，95%CI=3.5913.42）先兆子痫的风险显著高于回顾性研究（RR=2.60，95%CI=2.08~3.25）（Q=7.64，P=0.006）。
本研究表明，妊娠 SLE 患者先兆子痫的风险较高，提示 SLE 在先兆子痫发病机制中起关键作用。对于风湿病学家和 SLE 患者而言，保持疾病活动不活跃和预防 LN 等并发症，以及控制先兆子痫的传统危险因素同样重要。进一步研究关注 SLE 患者先兆子痫的预防也迫在眉睫。
