Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
J Trop Pediatr. 2021 Jul 2;67(3). doi: 10.1093/tropej/fmab058.
The purpose of the study was to determine the clinical features of NLE and to compare the neonatal outcomes between newborns born to pregnant women with SLE and healthy pregnant women.
We conducted a retrospective cohort analysis between 2007 and 2019 in a tertiary referral hospital in Thailand. A total of 118 pregnant women with SLE with 132 neonates compared with 264 randomly selected healthy pregnant women.
The median (interquartile range) gestational age and birth weight of 132 neonates born to women with SLE were 37 (35-38) weeks and 2687 g (2045-3160 g), respectively. The clinical features of NLE infants were hemolytic anemia (8%), thrombocytopenia (2.7%) and hyperbilirubinemia (5.3%). There was no neonate with a congenital complete heart block or skin lesion. Moreover, logistic regression analysis found that neonates born to women with SLE increased the risk of preterm birth [odd ratio (OR) 8.87, 95% confidence interval (95% CI) 4.32-18.21, p < 0.001], low birth weight (OR 10.35, 95% CI 5.08-21.08, p < 0.001), birth asphyxia (OR 2.91, 95% CI 1.26-6.73, p = 0.011) and NICU admission (OR 4.26, 95% CI 2.44-7.42, p < 0.001). SLE disease activity and corticosteroid and azathioprine usage were associated with preterm delivery in pregnant women with SLE.
The major clinical features of NLE patients were hematologic and hepatobiliary abnormalities in our study. Pregnancies with SLE dramatically increased the risk of preterm delivery and neonatal complications.
Neonatal lupus erythematosus (NLE) is the consequence of the transplacental passage of autoantibodies to newborns during pregnancy. The clinical features of NLE infants in our study were hemolytic anemia (8%), thrombocytopenia (2.7%) and hyperbilirubinemia (5.3%). There was no neonate with a congenital complete heart block or skin lesion. We also compared the neonatal outcomes between 118 pregnant women with SLE and 264 randomly selected healthy pregnant women. Our study found that the neonates born to women with SLE increased the risk of preterm birth, low birth weight, birth asphyxia and NICU admission. Moreover, SLE disease activity and corticosteroid and azathioprine usage were associated with preterm delivery in pregnant women with SLE.
本研究旨在确定新生儿狼疮（NLE）的临床特征，并比较患有系统性红斑狼疮（SLE）的孕妇所分娩的新生儿与健康孕妇所分娩的新生儿的围产儿结局。
我们对 2007 年至 2019 年在泰国一家三级转诊医院进行的回顾性队列研究进行了分析。共有 118 例患有 SLE 的孕妇及其 132 例新生儿与 264 例随机选择的健康孕妇进行了比较。
患有 SLE 的孕妇所分娩的 132 例新生儿的中位（四分位距）胎龄和出生体重分别为 37（35-38）周和 2687g（2045-3160g）。NLE 婴儿的临床特征为溶血性贫血（8%）、血小板减少症（2.7%）和高胆红素血症（5.3%）。没有新生儿患有先天性完全性心脏传导阻滞或皮肤病变。此外，logistic 回归分析发现，患有 SLE 的孕妇所分娩的新生儿早产的风险增加[比值比（OR）8.87，95%置信区间（95%CI）4.32-18.21，p<0.001]、出生体重低（OR 10.35，95%CI 5.08-21.08，p<0.001）、出生窒息（OR 2.91，95%CI 1.26-6.73，p=0.011）和新生儿重症监护病房（NICU）入院（OR 4.26，95%CI 2.44-7.42，p<0.001）的风险增加。SLE 疾病活动度和皮质类固醇和硫唑嘌呤的使用与 SLE 孕妇的早产有关。
在我们的研究中，NLE 患者的主要临床特征是血液学和肝胆异常。患有 SLE 的妊娠会显著增加早产和新生儿并发症的风险。
新生儿狼疮（NLE）是孕妇在怀孕期间通过胎盘将自身抗体传递给新生儿的结果。在我们的研究中，NLE 婴儿的临床特征为溶血性贫血（8%）、血小板减少症（2.7%）和高胆红素血症（5.3%）。没有新生儿患有先天性完全性心脏传导阻滞或皮肤病变。我们还比较了 118 例患有 SLE 的孕妇和 264 例随机选择的健康孕妇的围产儿结局。我们的研究发现，患有 SLE 的孕妇所分娩的新生儿早产、出生体重低、出生窒息和 NICU 入院的风险增加。此外，SLE 疾病活动度和皮质类固醇和硫唑嘌呤的使用与 SLE 孕妇的早产有关。
