Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto

Detalhes bibliográficos
Autor(a) principal: Santos, Flávia Cunha dos
Data de Publicação: 2020
Outros Autores: flaviacs@yahoo.com.br
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/19090
Resumo: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that can affect many organs and systems. It occurs predominantly in women and occurs most frequently during menacme between the second and third decades of life, a period that coincides with the usual gestation in the general population, and therefore, conception in women with SLE is not uncommon. Adverse outcomes are more frequent in pregnancies of women with SLE and these complications are even more common when conception occurs during periods of disease activity which increase the risk of miscarriages, intrauterine fetal death, preeclampsia, intrauterine growth restriction (IUGR), prematurity and premature rupture of membranes (PROM). The aim of the present study was to analyze PROM occurrence among 209 pregnancies of 190 women with SLE followed at Hospital Universitário Pedro Ernesto (HUPE), from 2011 to 2018. This is a cohort study with retrospective and prospective data collection, including patients with 4 or more SLE classification criteria (American College of Rheumatology criteria). Early and late gestational losses, cases of fetal malformations and multiple pregnancies were excluded. All included patients signed the approved informed consent form by the Research Ethics Committee of HUPE. Maternal clinical and laboratory characteristics, use of medications, clinical complications during pregnancy and obstetric outcomes were analyzed. Statistical analysis included Student's t-test, Mann-Whitney, chi-square (χ2) and Fisher's exact test. Determination of normal data distribution was analyzed with the Shapiro-Wilk test. The association of demographic variables, clinical manifestations of SLE, disease activity, damage index, medications used and comorbidities association with the PROM was assessend by logistic regression analysis with a significance level of 0.05. The patients mean age at delivery was 28.3 ± 6.1 years with a variation from 15 to 47 years and only 18.7% were planned. The occurrence of PROM was 28.7%, and infection (RR = 3.22), serositis (RR = 2.38) and AC anti RNP (RR = 2.99) were associated risk factors. The use of azathioprine (66.7% versus 41%, p = 0.02) and prednisone (81.5 versus 53.7%, p = 0.02) at the end of pregnancy was associated with preterm PROM (PPROM). PPROM occurred in 12.9% of the total pregnancies and in 45% of the cases of PROM, accounting for 37% of premature births. PROM, both at term and preterm, occurred more frequently than reported in the literature among pregnant women with SLE. Infections during pregnancy was a PROM risk factor. Patients with SLE are potentially more predisposed to clinical complications, and the use of immunosuppressive medications during pregnancy may make them more susceptible to PROM when they do not have anticipated delivery due to maternal or fetal complications.
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spelling Klumb, Evandro Mendeshttp://lattes.cnpq.br/3194331454644472Levy, Roger Abraminohttp://lattes.cnpq.br/5670143922234523Monteiro, Denise Leite Maiahttp://lattes.cnpq.br/5219627521398631Pinheiro, Geraldo da Rocha Castelarhttp://lattes.cnpq.br/3032582768442174Bica, Blanca Elena Rios Gomeshttp://lattes.cnpq.br/6502419885680651Sá, Renato Augusto Moreira dehttp://lattes.cnpq.br/7722814490587972http://lattes.cnpq.br/2911931825983890Santos, Flávia Cunha dosflaviacs@yahoo.com.br2023-02-27T13:47:19Z2020-01-15SANTOS, Flávia Cunha dos. Análise da ocorrência de rotura prematura das membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico acompanhadas no Hospital Universitário Pedro Ernesto. 2020. 116 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020.http://www.bdtd.uerj.br/handle/1/19090Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that can affect many organs and systems. It occurs predominantly in women and occurs most frequently during menacme between the second and third decades of life, a period that coincides with the usual gestation in the general population, and therefore, conception in women with SLE is not uncommon. Adverse outcomes are more frequent in pregnancies of women with SLE and these complications are even more common when conception occurs during periods of disease activity which increase the risk of miscarriages, intrauterine fetal death, preeclampsia, intrauterine growth restriction (IUGR), prematurity and premature rupture of membranes (PROM). The aim of the present study was to analyze PROM occurrence among 209 pregnancies of 190 women with SLE followed at Hospital Universitário Pedro Ernesto (HUPE), from 2011 to 2018. This is a cohort study with retrospective and prospective data collection, including patients with 4 or more SLE classification criteria (American College of Rheumatology criteria). Early and late gestational losses, cases of fetal malformations and multiple pregnancies were excluded. All included patients signed the approved informed consent form by the Research Ethics Committee of HUPE. Maternal clinical and laboratory characteristics, use of medications, clinical complications during pregnancy and obstetric outcomes were analyzed. Statistical analysis included Student's t-test, Mann-Whitney, chi-square (χ2) and Fisher's exact test. Determination of normal data distribution was analyzed with the Shapiro-Wilk test. The association of demographic variables, clinical manifestations of SLE, disease activity, damage index, medications used and comorbidities association with the PROM was assessend by logistic regression analysis with a significance level of 0.05. The patients mean age at delivery was 28.3 ± 6.1 years with a variation from 15 to 47 years and only 18.7% were planned. The occurrence of PROM was 28.7%, and infection (RR = 3.22), serositis (RR = 2.38) and AC anti RNP (RR = 2.99) were associated risk factors. The use of azathioprine (66.7% versus 41%, p = 0.02) and prednisone (81.5 versus 53.7%, p = 0.02) at the end of pregnancy was associated with preterm PROM (PPROM). PPROM occurred in 12.9% of the total pregnancies and in 45% of the cases of PROM, accounting for 37% of premature births. PROM, both at term and preterm, occurred more frequently than reported in the literature among pregnant women with SLE. Infections during pregnancy was a PROM risk factor. Patients with SLE are potentially more predisposed to clinical complications, and the use of immunosuppressive medications during pregnancy may make them more susceptible to PROM when they do not have anticipated delivery due to maternal or fetal complications.O lúpus eritematoso sistêmico (LES) é uma doença autoimune inflamatória crônica que pode afetar vários órgãos e sistemas. Ocorre predominantemente em mulheres e surge mais frequentemente durante a menacme entre a segunda e terceira décadas de vida, período que coincide com o habitual de gestação na população geral, sendo, portanto, não incomum a concepção em mulheres com LES. Existe uma maior frequência de desfechos adversos nas gestações de mulheres com LES e essas complicações são ainda mais comuns quando a concepção acontece em períodos de atividade da doença com aumento do risco de abortamentos espontâneos, óbito fetal intrauterino, pré-eclâmpsia, crescimento intrauterino restrito (CIUR), prematuridade e rotura prematura de membranas ovulares (RPMO). O objetivo do presente estudo foi analisar a ocorrência da rotura prematura das membranas ovulares (RPMO) em 209 gestações de 190 mulheres com LES acompanhadas no Hospital Universitário Pedro Ernesto (HUPE), no período de 2011 a 2018. Trata-se de estudo de coorte com coleta retrospectiva e prospectiva de dados, com inclusão de pacientes com 4 ou mais critérios de classificação de LES (critérios do Colégio Americano de Reumatologia). Foram excluídas as perdas gestacionais precoces e tardias, os casos de malformações fetais e as gestações múltiplas. Todas as pacientes incluídas assinaram termo de consentimento livre e esclarecido, aprovado pelo Comitê de Ética em Pesquisa do HUPE. Foram analisadas as características clínicas e laboratoriais maternas, uso de medicações, intercorrências clínicas durante a gestação e desfechos obstétricos. A análise estatística incluiu teste t de Student, Mann-Whitney, chi quadrado (χ2) e o teste exato de Fisher. A determinação quanto a distribuição normal dos dados foi analisada com o teste de Shapiro-Wilk. A associação das variáveis demográficas, manifestações clínicas do LES, atividade da doença, índice de danos, medicações utilizadas e comorbidades associadas com a RPMO, foi avaliada com regressão logística com nível de significância de 0,05. A idade das pacientes no momento do parto variou entre 15 e 47 anos com média de 28.3 ± 6,1 anos e apenas 18,7% foram planejadas. A ocorrência de RPMO foi de 28,7%, tendo infecção (RR=3,22), serosite (RR=2,38) e AC anti RNP (RR=2,99) como fatores de risco associados. O uso da azatioprina (66,7% versus 41%, p=0,02) e da prednisona (81,5 versus 53,7%, p=0,02) no final da gestação foi associado à RPMO pré-termo (RPPMO). A RPPMO ocorreu em 12,9% no total de gestações avaliadas e em 45% dos casos de RPMO, sendo responsável por 37% dos partos prematuros. A rotura prematura de membranas ovulares (RPMO) ocorreu mais frequentemente que a relatada na literatura nas gestantes com LES, tanto a termo como pré-termo. Infecções durante o período gestacional foram fatores de risco para RPMO. Pacientes com LES são potencialmente mais predispostas à intercorrências clínicas e o uso de medicações imunossupressoras durante a gravidez pode deixá-las mais suscetíveis a RPMO quando não tem o parto antecipado por intercorrências maternas ou fetais.Submitted by Heloísa CB/A (helobdtd@gmail.com) on 2023-02-27T13:47:19Z No. of bitstreams: 1 Tese - Flávia Cunha dos Santos - 2020 - Completo.pdf: 1936282 bytes, checksum: ff79a9d2c1809626cc558b2f5b3ef934 (MD5)Made available in DSpace on 2023-02-27T13:47:19Z (GMT). No. of bitstreams: 1 Tese - Flávia Cunha dos Santos - 2020 - Completo.pdf: 1936282 bytes, checksum: ff79a9d2c1809626cc558b2f5b3ef934 (MD5) Previous issue date: 2020-01-15application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBrasilCentro Biomédico::Faculdade de Ciências MédicasLúpus eritematoso sistêmicoGestaçãoRotura prematura de membranas ovularesResultados gestacionaisIntercorrências obstétricasSystemic lupus erythematosusPregnancyPremature rupture of ovular membranesPregnancy outcomesObstetric complicationsCIENCIAS DA SAUDE::MEDICINAAnálise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro ErnestoAnalysis of the occurrence of premature rupture of membranes in a cohort of women with systemic lupus erythematosus followed at Hospital Universitário Pedro Ernestoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Flávia Cunha dos Santos - 2020 - Completo.pdfTese - Flávia Cunha dos Santos - 2020 - Completo.pdfapplication/pdf1936282http://www.bdtd.uerj.br/bitstream/1/19090/2/Tese+-+Fl%C3%A1via+Cunha+dos+Santos+-+2020+-+Completo.pdfff79a9d2c1809626cc558b2f5b3ef934MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/19090/1/license.txte5502652da718045d7fcd832b79fca29MD511/190902024-02-26 15:59:50.68oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:59:50Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
dc.title.alternative.eng.fl_str_mv Analysis of the occurrence of premature rupture of membranes in a cohort of women with systemic lupus erythematosus followed at Hospital Universitário Pedro Ernesto
title Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
spellingShingle Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
Santos, Flávia Cunha dos
Lúpus eritematoso sistêmico
Gestação
Rotura prematura de membranas ovulares
Resultados gestacionais
Intercorrências obstétricas
Systemic lupus erythematosus
Pregnancy
Premature rupture of ovular membranes
Pregnancy outcomes
Obstetric complications
CIENCIAS DA SAUDE::MEDICINA
title_short Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
title_full Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
title_fullStr Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
title_full_unstemmed Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
title_sort Análise da ocorrência da rotura prematura de membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico, acompanhadas no Hospital Universitário Pedro Ernesto
author Santos, Flávia Cunha dos
author_facet Santos, Flávia Cunha dos
flaviacs@yahoo.com.br
author_role author
author2 flaviacs@yahoo.com.br
author2_role author
dc.contributor.advisor1.fl_str_mv Klumb, Evandro Mendes
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/3194331454644472
dc.contributor.advisor-co1.fl_str_mv Levy, Roger Abramino
dc.contributor.advisor-co1Lattes.fl_str_mv http://lattes.cnpq.br/5670143922234523
dc.contributor.referee1.fl_str_mv Monteiro, Denise Leite Maia
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/5219627521398631
dc.contributor.referee2.fl_str_mv Pinheiro, Geraldo da Rocha Castelar
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/3032582768442174
dc.contributor.referee3.fl_str_mv Bica, Blanca Elena Rios Gomes
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/6502419885680651
dc.contributor.referee4.fl_str_mv Sá, Renato Augusto Moreira de
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/7722814490587972
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2911931825983890
dc.contributor.author.fl_str_mv Santos, Flávia Cunha dos
flaviacs@yahoo.com.br
contributor_str_mv Klumb, Evandro Mendes
Levy, Roger Abramino
Monteiro, Denise Leite Maia
Pinheiro, Geraldo da Rocha Castelar
Bica, Blanca Elena Rios Gomes
Sá, Renato Augusto Moreira de
dc.subject.por.fl_str_mv Lúpus eritematoso sistêmico
Gestação
Rotura prematura de membranas ovulares
Resultados gestacionais
Intercorrências obstétricas
Systemic lupus erythematosus
Pregnancy
Premature rupture of ovular membranes
Pregnancy outcomes
Obstetric complications
topic Lúpus eritematoso sistêmico
Gestação
Rotura prematura de membranas ovulares
Resultados gestacionais
Intercorrências obstétricas
Systemic lupus erythematosus
Pregnancy
Premature rupture of ovular membranes
Pregnancy outcomes
Obstetric complications
CIENCIAS DA SAUDE::MEDICINA
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::MEDICINA
description Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that can affect many organs and systems. It occurs predominantly in women and occurs most frequently during menacme between the second and third decades of life, a period that coincides with the usual gestation in the general population, and therefore, conception in women with SLE is not uncommon. Adverse outcomes are more frequent in pregnancies of women with SLE and these complications are even more common when conception occurs during periods of disease activity which increase the risk of miscarriages, intrauterine fetal death, preeclampsia, intrauterine growth restriction (IUGR), prematurity and premature rupture of membranes (PROM). The aim of the present study was to analyze PROM occurrence among 209 pregnancies of 190 women with SLE followed at Hospital Universitário Pedro Ernesto (HUPE), from 2011 to 2018. This is a cohort study with retrospective and prospective data collection, including patients with 4 or more SLE classification criteria (American College of Rheumatology criteria). Early and late gestational losses, cases of fetal malformations and multiple pregnancies were excluded. All included patients signed the approved informed consent form by the Research Ethics Committee of HUPE. Maternal clinical and laboratory characteristics, use of medications, clinical complications during pregnancy and obstetric outcomes were analyzed. Statistical analysis included Student's t-test, Mann-Whitney, chi-square (χ2) and Fisher's exact test. Determination of normal data distribution was analyzed with the Shapiro-Wilk test. The association of demographic variables, clinical manifestations of SLE, disease activity, damage index, medications used and comorbidities association with the PROM was assessend by logistic regression analysis with a significance level of 0.05. The patients mean age at delivery was 28.3 ± 6.1 years with a variation from 15 to 47 years and only 18.7% were planned. The occurrence of PROM was 28.7%, and infection (RR = 3.22), serositis (RR = 2.38) and AC anti RNP (RR = 2.99) were associated risk factors. The use of azathioprine (66.7% versus 41%, p = 0.02) and prednisone (81.5 versus 53.7%, p = 0.02) at the end of pregnancy was associated with preterm PROM (PPROM). PPROM occurred in 12.9% of the total pregnancies and in 45% of the cases of PROM, accounting for 37% of premature births. PROM, both at term and preterm, occurred more frequently than reported in the literature among pregnant women with SLE. Infections during pregnancy was a PROM risk factor. Patients with SLE are potentially more predisposed to clinical complications, and the use of immunosuppressive medications during pregnancy may make them more susceptible to PROM when they do not have anticipated delivery due to maternal or fetal complications.
publishDate 2020
dc.date.issued.fl_str_mv 2020-01-15
dc.date.accessioned.fl_str_mv 2023-02-27T13:47:19Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv SANTOS, Flávia Cunha dos. Análise da ocorrência de rotura prematura das membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico acompanhadas no Hospital Universitário Pedro Ernesto. 2020. 116 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/19090
identifier_str_mv SANTOS, Flávia Cunha dos. Análise da ocorrência de rotura prematura das membranas ovulares em uma coorte de mulheres com lúpus eritematoso sistêmico acompanhadas no Hospital Universitário Pedro Ernesto. 2020. 116 f. Tese (Doutorado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2020.
url http://www.bdtd.uerj.br/handle/1/19090
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Ciências Médicas
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Centro Biomédico::Faculdade de Ciências Médicas
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
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