Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.
Universidade Estácio de Sá - Rio de Janeiro (RJ), Brazil.
Rev Assoc Med Bras (1992). 2022 Apr;68(4):536-541. doi: 10.1590/1806-9282.20220074.
The aim of this study was to analyze the occurrence and risk factors associated with infections during pregnancy in patients with systemic lupus erythematosus.
This is a retrospective cohort study using the data of pregnant women who were followed up between 2011 and 2018 at a university hospital.
The data of 221 pregnant women with systemic lupus erythematosus were analyzed. The incidence of infections was 22.6% (50/221), with the urinary tract being the most frequent site of infection (32/221, 14.5%) followed by the respiratory tract (15/221, 6.8%). The bivariate analysis showed that active disease, hematological systemic lupus erythematosus, reduced complement, and use of prednisone ≥5 and ≥10 mg increased the chance of infection during early pregnancy (p=0.05, p=0.04, p=0.003, p=0.008, and p=0.02, respectively), while disease activity and anti-DNA positivity increased it at the end of pregnancy (p=0.03 and p=0.04, respectively). Prednisone at a dose ≥5 mg increased the chance of infection in the beginning (p=0.01) and at the end of pregnancy (p=0.008). Multivariate analysis showed that increasing the dose of prednisone from 5 to 10 mg tripled the chance of developing infections in pregnant women with lupus (p=0.02).
The study showed an increased chance of infections in pregnant women with systemic lupus erythematosus and it was associated with the use of prednisone.
本研究旨在分析系统性红斑狼疮患者妊娠期间感染的发生情况及其相关危险因素。
这是一项回顾性队列研究，使用了 2011 年至 2018 年期间在一所大学医院接受随访的孕妇数据。
共分析了 221 例系统性红斑狼疮孕妇的数据。感染发生率为 22.6%（50/221），感染部位以尿路感染最常见（32/221，14.5%），其次为呼吸道感染（15/221，6.8%）。单因素分析显示，疾病活动度、血液系统受累、补体降低以及泼尼松使用剂量≥5mg 和≥10mg 增加了早期妊娠感染的机会（p=0.05、p=0.04、p=0.003、p=0.008 和 p=0.02），而疾病活动度和抗 DNA 阳性增加了晚期妊娠感染的机会（p=0.03 和 p=0.04）。泼尼松剂量≥5mg 增加了早期（p=0.01）和晚期妊娠（p=0.008）感染的机会。多因素分析显示，泼尼松剂量从 5mg 增加到 10mg 使狼疮孕妇感染的机会增加了两倍（p=0.02）。
本研究显示，系统性红斑狼疮孕妇感染的机会增加，与使用泼尼松有关。
