Cajamarca-Baron Jairo, Sanmiguel-Reyes Catalina, Bedoya-Loaiza Juan Esteban, Castañeda-Gonzalez Juan Pablo, Acelas-Gonzalez Gabriel E, Molina-Giraldo Saulo, Guavita-Navarro Diana, Ibáñez Claudia, Escobar Alejandro, Rojas-Villarraga Adriana
Rheumatologist, Hospital San José. Research Professor - Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá 111411, Colombia.
Rheumatologist, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá 111411, Colombia.
Autoimmun Rev. 2025 Mar 26;24(4):103744. doi: 10.1016/j.autrev.2025.103744. Epub 2025 Jan 12.
Systemic lupus erythematosus (SLE) predominantly affects women, especially during their reproductive years, leading to increased risks during pregnancy. Latina women develop SLE at a younger age, which increases their susceptibility to pregnancy complications such as pre-eclampsia, preterm birth and fetal growth restriction.
The purpose of this study is to systematically review maternal and fetal outcomes in pregnant Latina women with SLE and to perform a meta-analysis to assess specific risks associated with the disease.
A systematic review according to PRISMA guidelines was performed (PubMed and SciELO), including studies on SLE and pregnancy in Latin America through December 2022. Eligible studies included case reports, cohort studies and clinical trials in pregnant women with SLE. The meta-analysis focused on key outcomes, including pre-eclampsia and lupus nephritis, with relative risk (RR) calculations.
Forty-four studies with 2190 pregnancies were included. High rates of pre-eclampsia (11-52 %), preterm delivery (18.6-70.8 %), and fetal loss were reported. A decades-long analysis of pregnancy outcomes in SLE in Latin America shows increased research and improved care, with fetal loss rates decreasing from 35 % (1980-1999) to lower intrauterine (28 %) and neonatal (10 %) death rates in 2020-2023. Meta-analysis showed that lupus nephritis almost doubled the risk of pre-eclampsia (RR = 1.89, 95 % CI:1.40-2.55) compared to women without nephritis.
Latina women with SLE are at increased risk for adverse pregnancy outcomes, particularly pre-eclampsia and preterm delivery. Lupus nephritis and disease activity are major risk factors, highlighting the need for tailored care and early intervention to improve maternal and fetal outcomes in this population.
系统性红斑狼疮（SLE）主要影响女性，尤其是在生育年龄，导致孕期风险增加。拉丁裔女性患SLE的年龄更小，这增加了她们患先兆子痫、早产和胎儿生长受限等妊娠并发症的易感性。
本研究旨在系统回顾患有SLE的拉丁裔孕妇的母婴结局，并进行荟萃分析以评估与该疾病相关的特定风险。
根据PRISMA指南进行了系统回顾（PubMed和SciELO），纳入截至2022年12月关于拉丁美洲SLE与妊娠的研究。符合条件的研究包括SLE孕妇的病例报告、队列研究和临床试验。荟萃分析聚焦于关键结局，包括先兆子痫和狼疮性肾炎，并计算相对风险（RR）。
纳入了44项研究，涉及2190例妊娠。报告了先兆子痫（11%-52%）、早产（18.6%-70.8%）和胎儿丢失的高发生率。对拉丁美洲SLE妊娠结局长达数十年的分析表明，研究有所增加且护理得到改善，胎儿丢失率从1980 - 1999年的35%降至2020 - 2023年较低的宫内（28%）和新生儿（10%）死亡率。荟萃分析表明，与无肾炎的女性相比，狼疮性肾炎使先兆子痫的风险几乎增加了一倍（RR = 1.89，95% CI：1.40 - 2.55）。
患有SLE的拉丁裔女性不良妊娠结局的风险增加，尤其是先兆子痫和早产。狼疮性肾炎和疾病活动是主要风险因素，凸显了针对该人群进行个性化护理和早期干预以改善母婴结局的必要性。
