Department of Rheumatology, Tawam Hospital, Al Ain, UAE.
Internal Medicine Department, College of Medicine & Health Sciences, UAE University, Al Ain, UAE.
Lupus. 2023 Oct;32(12):1453-1461. doi: 10.1177/09612033231204650. Epub 2023 Oct 2.
To evaluate adverse pregnancy outcomes in patients with systemic lupus erythematosus (SLE), compare their maternal and fetal outcomes with those of age-matched pregnant women without SLE, and identify factors linked to increased risks of adverse outcomes.
Medical records from Tawam Hospital were reviewed retrospectively to identify patients with SLE and a history of pregnancy. Demographics, clinical variables, and maternal and fetal outcomes were obtained. A one-to-one age-matched healthy control group was randomly selected. The outcomes and odd ratios of women with and without SLE were compared, and factors associated with adverse pregnancy outcomes were examined.
The outcomes of 78 SLE pregnancies in 39 women were analyzed. Adverse maternal outcomes, such as gestational diabetes mellitus (GDM), occurred in 32% of pregnancies, whereas adverse fetal outcomes, such as low-birth weight and preterm deliveries, occurred in 51% of pregnancies. Pregnant women with SLE had a 5-fold higher risk of GDM, had higher odds of maternal hypertension, and were more likely to deliver through cesarean section than those without SLE. Preterm deliveries and low-birth weight were also more common in SLE pregnancies. Steroid use during pregnancy was significantly associated with an increased risk of GDM development. Lupus nephritis, maternal hypertension, pre-eclampsia, and GDM were linked to preterm deliveries.
Pregnant women with SLE were at a higher risk for adverse maternal and fetal outcomes than age-matched pregnant women without SLE. These findings can guide clinical management and emphasize the need for close monitoring of SLE pregnancies.
评估系统性红斑狼疮(SLE)患者的不良妊娠结局,将其母婴结局与无 SLE 的同龄妊娠妇女进行比较,并确定与不良结局风险增加相关的因素。
回顾性分析 Tawam 医院的病历,以确定患有 SLE 且有妊娠史的患者。获取人口统计学、临床变量以及母婴结局。随机选择一对一年龄匹配的健康对照组。比较有和无 SLE 的女性的结局和优势比,并检查与不良妊娠结局相关的因素。
分析了 39 名女性的 78 例 SLE 妊娠结局。不良的母体结局,如妊娠糖尿病(GDM),发生在 32%的妊娠中,而不良的胎儿结局,如低出生体重和早产,发生在 51%的妊娠中。患有 SLE 的孕妇发生 GDM 的风险高 5 倍,患母体高血压的几率更高,并且与无 SLE 的孕妇相比,更有可能通过剖宫产分娩。早产和低出生体重在 SLE 妊娠中也更为常见。妊娠期间使用类固醇与 GDM 发展风险增加显著相关。狼疮肾炎、母体高血压、子痫前期和 GDM 与早产有关。
与无 SLE 的同龄妊娠妇女相比,SLE 孕妇发生不良母婴结局的风险更高。这些发现可以指导临床管理,并强调需要密切监测 SLE 妊娠。