Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Division of Obstetrics and Gynaecology, Karolinska University Hospital, Stockholm, Sweden.
Lupus. 2021 Jun;30(7):1031-1038. doi: 10.1177/09612033211004716. Epub 2021 Apr 12.
Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN).
The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section.
Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035).
Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.
患有系统性红斑狼疮（SLE）的孕妇发生产科并发症（如子痫前期和早产）的风险增加。先前的研究表明，肾脏受累可能会进一步增加不良产科结局的风险。本研究旨在比较瑞典 SLE 患者伴或不伴狼疮肾炎（LN）的产科结局。
这是一项回顾性观察性研究，纳入了 2000 年至 2017 年在卡罗林斯卡大学医院分娩的 103 名 SLE 患者。35 名患者有既往或活动期 LN，68 名患者有非肾脏狼疮。数据来自电子病历。分析的结局包括胎儿出生体重小于胎龄（SGA）、早产、子痫前期、SLE 或肾炎发作和剖宫产。
LN 组（既往或妊娠期间有肾脏活动）的子痫前期发生率明显高于非肾脏狼疮组（25.7% vs 2.9%，p=0.001），且该并发症与早产（p=0.021）和剖宫产（p=0.035）相关。
狼疮肾炎是 SLE 患者不良产科结局的重要危险因素，包括子痫前期。这些患者可能受益于更频繁的产前检查和更积极的随访。
