Maternal and Fetal Outcomes in Iranian Patients with Systemic Lupus Erythematosus: A Five Year Retrospective Study of 60 Pregnancies

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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PNMED07_023

تاریخ نمایه سازی: 18 تیر 1398

Abstract:

As a multisystem autoimmune disease, systemic lupus erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE.Methods: Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016. Results: The mean age of the patients was 29.28±4.6 years and mean disease duration was 5.09±4.2 years. Live birth rate was 83.3% after exclusion of elective abortions. There were 50 live births, 3 neonatal deaths, 3 spontaneous abortions and 7 stillbirths. 9 (15%) women developed preeclampsia and there was 1 (1.6%) case of HELLP syndrome. Lupus flares occurred in 27 (45%) patients during pregnancy. Preterm delivery occurred in 11.6% of pregnancies. Skin and joints were the most frequently affected organs. Patients with previous lupus nephritis (n=18) were associated with a higher risk of maternal complication, but fetal outcomes were similar in both groups. Cesarean rate was about 66%, mostly related to fetal indications (50%).Conclusion: Pregnancies in most women with pre-existing SLE can now be managed with successful results although presence of previous lupus nephritis is still a major risk factor for adverse maternal outcomes. In our study, fetal outcome was not different between patients with lupus nephritis compared with the patients without nephritis who were under treatments. Hence, to achieve favorable long-term results, we recommend regular multispecialty treatment approaches and progestational counseling for women with SLE

Authors

P Karimzadeh

Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Sciences, Iran

S Shenavandeh

Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Sciences, Iran

N Asadi

Department of OB and GYN, Shiraz University of Medical Sciences, Iran