Rahman P, Gladman D D, Urowitz M B
The University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, University of Toronto, Ontario, Canada.
J Rheumatol. 1998 Aug;25(8):1526-30.
To describe the fetal outcomes in systemic lupus erythematosus (SLE) in the University of Toronto Lupus Clinic Cohort and to identify clinical or serological factors that would predict pregnancy loss and poor fetal outcome.
Seventy-three patients with 141 pregnancies were identified between 1970 and 1995. Patients were evaluated before pregnancy and at each trimester with a standardized protocol. Analysis included descriptive statistics and univariate and multivariate analysis.
There were 86 (60.1%) live births, 34 (23.8%) spontaneous abortions, 3 (2.2%) stillbirths, and 20 (14%) therapeutic abortions. Of live births, 21 (24.4%) were premature babies, 6 (7.9%) intrauterine growth retardation, 3 (3.5%) had neonatal lupus, 2 (2.3%) congenital malformations, and there were 2 (2.3%) perinatal deaths. Maternal renal disease was the only statistically significant predictor for fetal loss (p<0.0 12) and hypertension for poor fetal outcome (p<0.024) using univariate analysis.
Most lupus pregnancies do well, but there is an increased incidence of adverse fetal outcome. Predictive factors for adverse fetal outcome include maternal renal disease and hypertension.
描述多伦多大学狼疮诊所队列中系统性红斑狼疮（SLE）患者的胎儿结局，并确定可预测流产和不良胎儿结局的临床或血清学因素。
在1970年至1995年期间确定了73例患者的141次妊娠。在妊娠前及每个孕期采用标准化方案对患者进行评估。分析包括描述性统计以及单因素和多因素分析。
有86例（60.1%）活产，34例（23.8%）自然流产，3例（2.2%）死产，20例（14%）治疗性流产。在活产中，21例（24.4%）为早产儿，6例（7.9%）胎儿宫内生长受限，3例（3.5%）有新生儿狼疮，2例（2.3%）有先天性畸形，还有2例（2.3%）围产期死亡。单因素分析显示，母亲肾病是胎儿丢失的唯一具有统计学意义的预测因素（p<0.012），而高血压是不良胎儿结局的预测因素（p<0.024）。
大多数狼疮患者妊娠情况良好，但不良胎儿结局的发生率有所增加。不良胎儿结局的预测因素包括母亲肾病和高血压。
