Devoe L D, Loy G L
Obstet Gynecol. 1984 Jun;63(6):796-800.
Previous reports suggest an association between maternal serum complement component (C3 and C4) levels and perinatal outcome. Eighteen women with systemic lupus erythematosus (21 pregnancies) were prospectively studied. C3 and C4 levels were measured monthly unless more frequent data were needed for acute medical management. Perinatal outcome was then correlated with both maternal clinical and serologic status before and during pregnancy. Twelve pregnancies were carried to term, 11 of which began in clinical remission. Eight of these 12 had normal C3 and C4 levels at the onset of pregnancy, and 11 were normal at delivery. Four pregnancies were delivered prematurely (with one neonatal death from septic meningitis); all began pregnancy in clinical remission but three had low C3 and C4 levels before delivery. Three pregnancies beginning in clinical remission ended in spontaneous first- or early second-trimester abortions; all had low C3 and C4 levels before aborting. Normal complement component levels were observed in the remaining two pregnancies that were terminated electively; they had no evidence of fetal or placental abnormality. The correlation of maternal serum complement levels and pregnancy outcome in this series suggests that these parameters may help in the assessment of fetal as well as maternal prognosis in lupus-complicated gestations.
先前的报告表明，母体血清补体成分（C3和C4）水平与围产期结局之间存在关联。对18名患有系统性红斑狼疮的女性（21次妊娠）进行了前瞻性研究。每月测量C3和C4水平，除非急性医疗处理需要更频繁的数据。然后将围产期结局与妊娠前和妊娠期间的母体临床及血清学状态进行关联分析。12次妊娠足月分娩，其中11次妊娠开始时处于临床缓解期。这12次妊娠中有8次在妊娠开始时C3和C4水平正常，11次在分娩时正常。4次妊娠早产（其中1例新生儿因败血症性脑膜炎死亡）；所有妊娠开始时均处于临床缓解期，但3例在分娩前C3和C4水平较低。3次妊娠开始时处于临床缓解期，在妊娠早期或孕中期自发流产；所有流产前C3和C4水平均较低。其余2次选择性终止妊娠的妊娠中，补体成分水平正常；未发现胎儿或胎盘异常的证据。本系列研究中母体血清补体水平与妊娠结局的相关性表明，这些参数可能有助于评估狼疮合并妊娠时的胎儿及母体预后。
