Kleinman D, Katz V L, Kuller J A
Department of Obstetrics and Gynecology, University of North Carolina, Durham, USA.
J Perinatol. 1998 May-Jun;18(3):178-82.
Pregnancies of women with systemic lupus erythematosus (SLE) were studied to assess the effects interaction of this disease and pregnancy.
Charts of pregnant women with a discharge diagnosis of lupus were reviewed. Inclusion criterion was SLE diagnosed by the criteria of the American College of Rheumatology. All patients were cared for at the University of North Carolina Hospitals, a tertiary level university center.
Between January 1988 and June 1995, we participated in the care of 21 women with the diagnosis of SLE. Their obstetric histories included a total of 56 pregnancies spanning 19 years. Obstetric histories were divided into pregnancies occurring before the patient was diagnosed with lupus and those pregnancies occurring after she had been given the diagnosis. The diagnosis of lupus was made during the course of five pregnancies; those five were categorized as occurring after diagnosis. Of the pregnancies that occurred before a woman's diagnosis of SLE, 46% resulted in live births, 36% ended in spontaneous abortion, and 18% ended in an intrauterine fetal demise. Among pregnancies occurring after the diagnosis of SLE, 85% resulted in live birth, 10% in spontaneous abortion, 3.3% in intrauterine fetal demise, and 3.3% in neonatal death. Of all live births, 53% were delivered before 37 weeks' gestation. The most common causes of maternal morbidity were joint involvement (n = 8) and dermatologic disorders (n = 6). Other clinical manifestations of SLE included nephritis (n = 5), hypertension (n = 4), pleuritis (n = 3), and thrombocytopenia (n = 3). One maternal death occurred as a result of pulmonary disease. Four pregnancies were complicated by preeclampsia. Seven patients were hospitalized during their pregnancies for lupus-related complications.
Substantial fetal, neonatal, and maternal risks still exist for pregnant women with lupus.
研究系统性红斑狼疮（SLE）女性的妊娠情况，以评估该疾病与妊娠相互作用的影响。
回顾了出院诊断为狼疮的孕妇病历。纳入标准为根据美国风湿病学会标准诊断的SLE。所有患者均在北卡罗来纳大学医院接受治疗，该医院为三级大学中心。
1988年1月至1995年6月期间，我们参与了21例诊断为SLE的女性的护理。她们的产科病史包括19年间的56次妊娠。产科病史分为患者被诊断为狼疮之前发生的妊娠和诊断后发生的妊娠。在5次妊娠过程中确诊为狼疮；这5次被归类为诊断后发生的妊娠。在女性被诊断为SLE之前发生的妊娠中，46%为活产，36%以自然流产告终，18%以宫内胎儿死亡告终。在诊断为SLE后发生的妊娠中，85%为活产，10%为自然流产，3.3%为宫内胎儿死亡，3.3%为新生儿死亡。在所有活产中，53%在妊娠37周前分娩。孕产妇发病的最常见原因是关节受累（n = 8）和皮肤病（n = 6）。SLE的其他临床表现包括肾炎（n = 5）、高血压（n = 4）、胸膜炎（n = 3）和血小板减少症（n = 3）。1例孕产妇因肺部疾病死亡。4次妊娠并发先兆子痫。7例患者在妊娠期间因狼疮相关并发症住院。
狼疮孕妇仍存在重大的胎儿、新生儿和孕产妇风险。
