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- Title
Lupus Low Disease Activity State Achievement Is Important for Reducing Adverse Outcomes in Pregnant Patients With Systemic Lupus Erythematosus.
- Authors
Ji-Won Kim; Ju-Yang Jung; Hyoun-Ah Kim; Yang, Jeong I.; Kwak, Dong W.; Chang-Hee Suh; Kim, Ji-Won; Jung, Ju-Yang; Kim, Hyoun-Ah; Suh, Chang-Hee
- Abstract
<bold>Objective: </bold>This study aimed to examine the frequency and risk factors of complications during pregnancy in women with systemic lupus erythematosus (SLE).<bold>Methods: </bold>The medical records of patients with SLE and age-matched controls at Ajou University Hospital were collected. Clinical features and pregnancy complications in women with SLE were compared to those of the controls. Multivariate logistic regression analysis was performed to determine the predictors of adverse maternal and fetal outcomes.<bold>Results: </bold>We analyzed 163 pregnancies in patients with SLE and 596 pregnancies in the general population; no significant differences regarding demographic characteristics were noted. Patients with SLE experienced a higher rate of stillbirth (OR 13.2), preeclampsia (OR 4.3), preterm delivery (OR 2.8), intrauterine growth retardation (OR 2.5), admission to neonatal intensive care unit (OR 2.2), and emergency cesarean section (OR 1.9) than the control group. Multivariate regression analysis revealed that thrombocytopenia, low complement, high proteinuria, high SLE Disease Activity Index (SLEDAI), low Lupus Low Disease Activity State (LLDAS) achievement rate, and high corticosteroid (CS) dose were associated with adverse pregnancy outcomes. In the receiver-operating characteristic curve analysis, the optimal cutoff value for the cumulative and mean CS doses were 3500 mg and 6 mg, respectively.<bold>Conclusion: </bold>Pregnant women with SLE have a higher risk of adverse pregnancy outcomes. Pregnancies are recommended to be delayed until achieving LLDAS and should be closely monitored with the lowest possible dose of CS.
- Subjects
ADRENOCORTICAL hormones; SYSTEMIC lupus erythematosus; PREGNANCY complications; STILLBIRTH; PREECLAMPSIA; PREMATURE labor; FETAL growth retardation; RESEARCH; RESEARCH methodology; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; PREGNANCY outcomes; COMPARATIVE studies; SEVERITY of illness index; CESAREAN section; DISEASE complications
- Publication
Journal of Rheumatology, 2021, Vol 48, Issue 5, p707
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.200802