Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus

Detalhes bibliográficos
Autor(a) principal: Palma dos Reis, Catarina R.
Data de Publicação: 2020
Outros Autores: Cardoso, Gonçalo, Carvalho, Carolina, Nogueira, Isabel, Borges, Augusta, Serrano, Fátima
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/147410
Resumo: Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease associated with major obstetrical complications such as gestational loss, preterm delivery, fetal growth restriction (FGR) and preeclampsia. Published literature is not consensual regarding the main risk factors for each of these outcomes. Our goal with this study was to determine the most important predictors for each of the main adverse pregnancy outcomes in this population. We conducted a retrospective cohort study of unifetal pregnancies of women with the diagnosis of SLE followed in our unit between January 1994 and December 2016. We excluded elective terminations of pregnancy and cases lost to follow-up and we analyzed 157 pregnancies (128 women). Multiple logistic regression models for the outcomes gestational loss, preterm delivery, fetal growth restriction, and preeclampsia were built. Two-sided p-values of < 0.05 were used to determine statistical significance, and two-sided confidence intervals of 95% are reported. In our cohort, the main risk factors for gestational loss were maternal age and the presence of antiphospholipid antibodies. Lupic nephritis was predictive of a preterm delivery and preeclampsia. Renal involvement and lupus flares during pregnancy were risk factors for FGR. Overall, the main risk factor for an adverse pregnancy outcome were lupus flares during pregnancy. Despite optimal pregnancy monitoring, women with SLE are still at risk for adverse pregnancy outcomes. Risk stratification for each of these outcomes is crucial for an effective counselling and tailored monitoring.
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spelling Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus ErythematosusFetal growth restrictionGestational lossPreeclampsiaPregnancyPreterm birthSystemic lupus erythematosusImmunology and AllergySystemic lupus erythematosus (SLE) is a chronic, autoimmune disease associated with major obstetrical complications such as gestational loss, preterm delivery, fetal growth restriction (FGR) and preeclampsia. Published literature is not consensual regarding the main risk factors for each of these outcomes. Our goal with this study was to determine the most important predictors for each of the main adverse pregnancy outcomes in this population. We conducted a retrospective cohort study of unifetal pregnancies of women with the diagnosis of SLE followed in our unit between January 1994 and December 2016. We excluded elective terminations of pregnancy and cases lost to follow-up and we analyzed 157 pregnancies (128 women). Multiple logistic regression models for the outcomes gestational loss, preterm delivery, fetal growth restriction, and preeclampsia were built. Two-sided p-values of < 0.05 were used to determine statistical significance, and two-sided confidence intervals of 95% are reported. In our cohort, the main risk factors for gestational loss were maternal age and the presence of antiphospholipid antibodies. Lupic nephritis was predictive of a preterm delivery and preeclampsia. Renal involvement and lupus flares during pregnancy were risk factors for FGR. Overall, the main risk factor for an adverse pregnancy outcome were lupus flares during pregnancy. Despite optimal pregnancy monitoring, women with SLE are still at risk for adverse pregnancy outcomes. Risk stratification for each of these outcomes is crucial for an effective counselling and tailored monitoring.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNPalma dos Reis, Catarina R.Cardoso, GonçaloCarvalho, CarolinaNogueira, IsabelBorges, AugustaSerrano, Fátima2023-01-12T22:11:12Z2020-122020-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/147410eng1080-0549PURE: 14545520https://doi.org/10.1007/s12016-019-08762-9info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:28:30Zoai:run.unl.pt:10362/147410Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:52:54.352894Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
title Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
spellingShingle Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
Palma dos Reis, Catarina R.
Fetal growth restriction
Gestational loss
Preeclampsia
Pregnancy
Preterm birth
Systemic lupus erythematosus
Immunology and Allergy
title_short Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
title_full Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
title_fullStr Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
title_full_unstemmed Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
title_sort Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus
author Palma dos Reis, Catarina R.
author_facet Palma dos Reis, Catarina R.
Cardoso, Gonçalo
Carvalho, Carolina
Nogueira, Isabel
Borges, Augusta
Serrano, Fátima
author_role author
author2 Cardoso, Gonçalo
Carvalho, Carolina
Nogueira, Isabel
Borges, Augusta
Serrano, Fátima
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Palma dos Reis, Catarina R.
Cardoso, Gonçalo
Carvalho, Carolina
Nogueira, Isabel
Borges, Augusta
Serrano, Fátima
dc.subject.por.fl_str_mv Fetal growth restriction
Gestational loss
Preeclampsia
Pregnancy
Preterm birth
Systemic lupus erythematosus
Immunology and Allergy
topic Fetal growth restriction
Gestational loss
Preeclampsia
Pregnancy
Preterm birth
Systemic lupus erythematosus
Immunology and Allergy
description Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease associated with major obstetrical complications such as gestational loss, preterm delivery, fetal growth restriction (FGR) and preeclampsia. Published literature is not consensual regarding the main risk factors for each of these outcomes. Our goal with this study was to determine the most important predictors for each of the main adverse pregnancy outcomes in this population. We conducted a retrospective cohort study of unifetal pregnancies of women with the diagnosis of SLE followed in our unit between January 1994 and December 2016. We excluded elective terminations of pregnancy and cases lost to follow-up and we analyzed 157 pregnancies (128 women). Multiple logistic regression models for the outcomes gestational loss, preterm delivery, fetal growth restriction, and preeclampsia were built. Two-sided p-values of < 0.05 were used to determine statistical significance, and two-sided confidence intervals of 95% are reported. In our cohort, the main risk factors for gestational loss were maternal age and the presence of antiphospholipid antibodies. Lupic nephritis was predictive of a preterm delivery and preeclampsia. Renal involvement and lupus flares during pregnancy were risk factors for FGR. Overall, the main risk factor for an adverse pregnancy outcome were lupus flares during pregnancy. Despite optimal pregnancy monitoring, women with SLE are still at risk for adverse pregnancy outcomes. Risk stratification for each of these outcomes is crucial for an effective counselling and tailored monitoring.
publishDate 2020
dc.date.none.fl_str_mv 2020-12
2020-12-01T00:00:00Z
2023-01-12T22:11:12Z
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 1080-0549
PURE: 14545520
https://doi.org/10.1007/s12016-019-08762-9
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