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自身免疫性疾病女性的妊娠及围产期结局

Maternal and Perinatal Outcomes of Pregnancy in Women With Autoimmune Disorder.

作者信息

Singhal Seema, Meena Jyoti, Kumar Sunesh, Roy K K, Singh Neeta, Shekhar Bhawani, Yadav Anshu, Kumari Sarita, Jayraj Aarthi S

机构信息

Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, IND.

出版信息

Cureus. 2021 Jun 29;13(6):e16024. doi: 10.7759/cureus.16024. eCollection 2021 Jun.

Abstract

Objective Pregnancy with an autoimmune disorder is faced with several risks for mother and fetus. The aim of the present study is to analyze the course and outcome of pregnancy in women with autoimmune disorders (AIDs). Methods A retrospective cohort study was conducted at a tertiary care teaching hospital. The hospital records of 153 pregnancies with autoimmune disorders and 1095 low-risk pregnant women who served as controls were reviewed. An adverse perinatal outcome was defined as the presence of any obstetric complications, including preeclampsia, eclampsia, abruption, antepartum hemorrhage (APH), prematurity, fetal growth restriction (FGR), intrauterine death (IUD), intrapartum event, mode of delivery, birth weight, neonatal intensive care unit (NICU) stay, or disease-specific neonatal complications. For all statistical tests with two-tailed probability, p<0.05 was considered statistically significant. Results A high incidence of adverse perinatal outcomes was observed in all women with AIDs when compared with age-matched controls. The highest incidence of adverse perinatal outcomes was observed in women with Takayasu's arteritis. The incidence of abortions was more in women with antiphospholipid antibody syndrome (APS) and Grave's disease (22.2% and 33.3%, respectively). The incidence of prematurity, fetal growth restriction (FGR), and low birth weight were highest in women with systemic lupus erythematosus (SLE). Pregnancy with myasthenia gravis and rheumatoid arthritis did not have any significant adverse impact on pregnancy outcomes. Conclusion We found a strong association between autoimmune disorders and obstetric complications. The multidisciplinary team approach and pre-pregnancy optimization of the disease improve maternal and fetal outcomes.

摘要

目的 患有自身免疫性疾病的孕妇面临着对母亲和胎儿的多种风险。本研究的目的是分析患有自身免疫性疾病(AIDs)的女性的妊娠过程和结局。方法 在一家三级护理教学医院进行了一项回顾性队列研究。回顾了153例患有自身免疫性疾病的孕妇和1095例作为对照的低风险孕妇的医院记录。不良围产期结局定义为存在任何产科并发症,包括先兆子痫、子痫、胎盘早剥、产前出血(APH)、早产、胎儿生长受限(FGR)、宫内死亡(IUD)、产时事件、分娩方式、出生体重、新生儿重症监护病房(NICU)住院时间或特定疾病的新生儿并发症。对于所有双侧概率的统计检验,p<0.05被认为具有统计学意义。结果 与年龄匹配的对照组相比,所有患有AIDs的女性中不良围产期结局的发生率都很高。在高安动脉炎女性中观察到不良围产期结局的发生率最高。抗磷脂抗体综合征(APS)和格雷夫斯病女性的流产发生率更高(分别为22.2%和33.3%)。系统性红斑狼疮(SLE)女性的早产、胎儿生长受限(FGR)和低出生体重发生率最高。重症肌无力和类风湿关节炎患者的妊娠对妊娠结局没有任何显著的不良影响。结论 我们发现自身免疫性疾病与产科并发症之间存在密切关联。多学科团队方法和疾病的孕前优化可改善母婴结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb20/8320712/698347088749/cureus-0013-00000016024-i01.jpg

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