Clinical predictors of fetal and maternal outcome in systemic lupus erythematosus: a prospective study of 103 pregnancies
Objective. Our aim was to assess the outcome of pregnancy in a cohort of patients with SLE and to evaluate clinical and laboratory markers for fetal outcome and maternal flares. Methods. Sixty patients with 103 pregnancies were evaluated prospectively between 1984 and 1999. Results. There were 68 li...
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Published in | Rheumatology (Oxford, England) Vol. 41; no. 6; pp. 643 - 650 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Oxford University Press
01.06.2002
Oxford Publishing Limited (England) |
Subjects | |
Online Access | Get full text |
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Summary: | Objective. Our aim was to assess the outcome of pregnancy in a cohort of patients with SLE and to evaluate clinical and laboratory markers for fetal outcome and maternal flares. Methods. Sixty patients with 103 pregnancies were evaluated prospectively between 1984 and 1999. Results. There were 68 live births, 15 spontaneous abortions, 12 stillbirths and eight therapeutic abortions. Of liveborn infant births, 19 were premature, 24 had suffered intrauterine growth restriction and one had neonatal lupus. Maternal lupus flares occurred in 33% of pregnancies, mostly in the second trimester (26%) and in the post‐partum period (51%). Flares during pregnancy showed a statistically significant association with discontinuation of chloroquine treatment, a history of more than three flares before gestation, and a SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) score of ≥5 in these flares. Antiphospholipid antibodies, C3 hypocomplementaemia and hypertension during pregnancy were significantly associated with fetal loss, prematurity and intrauterine growth restriction. Conclusions. Patients with more active SLE and those with aPL antibodies and hypertension should be monitored and managed carefully during pregnancy. |
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Bibliography: | istex:EEC835E507874F3CA6F64BF77AFF23615F80DEA4 local:410643 ark:/67375/HXZ-4SG89F64-M PII:1460-2172 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1462-0324 1462-0332 |
DOI: | 10.1093/rheumatology/41.6.643 |