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Systemic erythematosus lupus and pregnancy outcomes in a Colombian cohort.
- Source :
-
Lupus [Lupus] 2021 Dec; Vol. 30 (14), pp. 2310-2317. Date of Electronic Publication: 2021 Dec 07. - Publication Year :
- 2021
-
Abstract
- Objective: Pregnant women with SLE have higher probabilities of maternal complications. SLE during pregnancy has alternating patterns of remission and flare-ups; however, most pregnant SLE patients tend to worsen with associated poor obstetric and perinatal outcomes. This study aimed to describe obstetric outcomes in pregnant women with SLE.<br />Methods: This retrospective study was performed between 2011 and 2020 at a highly complex referral health center in Cali, Colombia. Pregnant women with a diagnosis of SLE were included. Demographic, clinical, and laboratory features and obstetric and fetal outcomes, including intensive care unit (ICU) characteristics, were evaluated.<br />Results: Forty-eight pregnant women with SLE were included. The median age was 29 (25-33.7) years. The SLE diagnosis was made before pregnancy in 38 (79.1%) patients, with a median disease duration of 46 (12-84) months. Thirteen (27.1%) patients had lupus nephritis. Preterm labor (34, 70.8%), preeclampsia (25, 52%), and preterm rupture of membranes (10, 20.8%) were the most common obstetric complications. A relationship between a greater systemic lupus erythematosus pregnancy disease activity index (SLEPDAI) and the development of hypertensive disorders during pregnancy was established (preeclampsia = p < 0.0366; eclampsia = p < 0.0153). A relationship was identified between lupus nephritis (LN) and eclampsia ( p < 0.01), preterm labor ( p < 0.045), and placental abruption ( p < 0.01). Seventeen (35.4%) patients required ICU admission; 52.9% of them were due to AID activity, 17.6% for cardiovascular damage, 11.7% for septic shock, and 5.8% for acute kidney failure. Fetal survival was 89.5% ( N = 43/48). Among the live births, two (4.2%) newborns were diagnosed with neonatal lupus, and two (4.2%) were diagnosed with congenital heart block. One maternal death was registered due to preeclampsia and intraventricular hemorrhage.<br />Conclusions: This study is the first to describe SLE during pregnancy in Colombia. SLE was the most prevalent AID in this cohort, and complications included preterm labor, preeclampsia, and postpartum hemorrhage. A higher SLEPDAI and lupus nephritis predicted adverse maternal outcomes.
- Subjects :
- Adult
Colombia epidemiology
Female
Humans
Infant, Newborn
Placenta
Pregnancy
Pregnancy Outcome epidemiology
Retrospective Studies
Eclampsia
Lupus Erythematosus, Discoid
Lupus Erythematosus, Systemic complications
Lupus Erythematosus, Systemic epidemiology
Lupus Nephritis epidemiology
Obstetric Labor, Premature epidemiology
Obstetric Labor, Premature etiology
Pre-Eclampsia epidemiology
Pregnancy Complications epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1477-0962
- Volume :
- 30
- Issue :
- 14
- Database :
- MEDLINE
- Journal :
- Lupus
- Publication Type :
- Academic Journal
- Accession number :
- 34874750
- Full Text :
- https://doi.org/10.1177/09612033211061478