JOURNAL ARTICLE

[Influential factors of systemic lupus erythematosus activity during pregnancy and its relationship with pregnancy outcome]

Yun-hui Wang, Xiao-xia Wu, Jian-ping Tan, Jian-ping Zhang
Zhonghua Fu Chan Ke za Zhi 2006, 41 (9): 601-4
17181969

OBJECTIVE: To investigate the influential factors of systemic lupus erythematosus (SLE) activity during pregnancy and their relationship with pregnancy outcome.

METHODS: A retrospective analysis of the clinical history of 66 pregnant women with SLE from 1991 to 2005 was carried out.

RESULTS: (1) Those patients with unstable status progestation, patients being newly diagnosed with SLE during pregnancy or patients irregularly using prednisone became active during pregnancy. The disease was active in 32 cases (the active group) and inactive in 34 cases (the inactive group). (2) Obstetric complications in the active group included: 9 cases of preeclampsia, 13 cases of fetal growth restriction (FGR), 7 cases of therapeutic abortion and 15 cases of premature labor; and the corresponding numbers in the inactive group were 1, 5, 1 and 4, respectively. All the numbers were significantly different between the two groups (P < 0.05). (3) Among all SLE injuries, the lupus nephropathy affected pregnancy mostly. With the logistic regression advanced method, we found the lupus nephropathy was the independent risk factor for preeclampsia and FGR. (4) The rates of preeclampsia, and fetal losses were 4.7% (2/43) and 9.3% (4/43) in the patients taking prednisone less than 15 mg/day, and were 33.3% (6/18) and 44.4% (8/18) in the patients taking prednisone more than 20 mg/day, being significantly different from the former (P < 0.01).

CONCLUSIONS: Being unstable progestation, being newly diagnosed during pregnancy or irregular prednisone use are important influential factors of SLE activity. SLE flares during pregnancy, especially the lupus nephropathy correlate closely with the adverse pregnancy outcomes. The rates of preeclampsia, and fetal losses increase in the patients taking prednisone more than 20 mg/day compared with the patients taking prednisone less than 15 mg/day.

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