Khogali Hiba I, Alhebsi Aaesha M, Altamimi Meera A, Al-Bluwi Ghada Sm, Guy Pedo Virgie, Al Dhanhani Ali M
Department of Rheumatology, Tawam Hospital, Al Ain, UAE.
Medical Interns, College of Medicine & Health Science, UAE University, Al Ain, UAE.
Lupus. 2025 Jun;34(7):705-712. doi: 10.1177/09612033251344195. Epub 2025 May 21.
ObjectiveSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that predominantly affects females. SLE poses risks to the mother and fetus during pregnancy. Information on infection rates during pregnancy in patients with SLE is scarce. Therefore, this study assessed infection risk during pregnancy in women with and without SLE, and identified the factors influencing susceptibility to infections.MethodsWe conducted a retrospective cohort analysis using medical records from Tawam Hospital, Abu Dhabi, United Arab Emirates. Emirati women diagnosed with SLE who experienced one or more pregnancies between January 2010 and August 2023 were included in the study. Patients with SLE were compared with an age-matched control group of women without SLE. The control group was systematically selected from the hospital records of the same period. Demographic details, clinical data, and comprehensive infection histories during and before pregnancy were examined. Univariate and multivariate regression analyses were used to identify the factors contributing to the risk of infection in pregnant women with SLE.ResultsData from 87 pregnancies in 41 women with SLE were analyzed. The mean age at conception was higher in women with SLE compared to the control group. The rates of infections (54.7% vs 29.8%), adverse fetal outcomes (48.3% vs 24.2%), and maternal outcomes (71.3% vs 43%) were significantly higher in the SLE group than in the control group. Respiratory infections were the most prevalent infection type. No variable was found to increase the risk of infection; however, hydroxychloroquine use during pregnancy was significantly associated with a reduced risk of infection.ConclusionsThe risks of infection and adverse outcomes are significantly higher in pregnant women with SLE than in the non-SLE population. Hydroxychloroquine use during pregnancy was crucial in reducing infection risk. These findings underscore the need for targeted interventions and a multidisciplinary care approach to improve pregnancy outcomes in women with SLE.
目的
系统性红斑狼疮（SLE）是一种异质性自身免疫性疾病，主要影响女性。SLE在孕期会给母亲和胎儿带来风险。关于SLE患者孕期感染率的信息匮乏。因此，本研究评估了患有和未患有SLE的女性在孕期的感染风险，并确定了影响感染易感性的因素。
方法
我们使用了阿拉伯联合酋长国阿布扎比塔瓦姆医院的病历进行回顾性队列分析。纳入了2010年1月至2023年8月期间诊断为SLE且经历过一次或多次妊娠的阿联酋女性。将SLE患者与年龄匹配的未患SLE的女性对照组进行比较。对照组是从同一时期的医院记录中系统选取的。检查了人口统计学细节、临床数据以及孕期和孕前的全面感染史。采用单因素和多因素回归分析来确定导致SLE孕妇感染风险的因素。
结果
分析了41例SLE女性的87次妊娠数据。与对照组相比，SLE女性的平均受孕年龄更高。SLE组的感染率（54.7%对29.8%）、不良胎儿结局发生率（48.3%对24.2%）和母亲结局发生率（71.3%对43%）显著高于对照组。呼吸道感染是最常见的感染类型。未发现有变量会增加感染风险；然而，孕期使用羟氯喹与感染风险降低显著相关。
结论
SLE孕妇的感染风险和不良结局显著高于非SLE人群。孕期使用羟氯喹对降低感染风险至关重要。这些发现强调了需要采取针对性干预措施和多学科护理方法来改善SLE女性的妊娠结局。
