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PLoS One. 2014 Aug 13;9(8):e104375. doi: 10.1371/journal.pone.0104375. eCollection 2014.

Pregnancy-related systemic lupus erythematosus: clinical features, outcome and risk factors of disease flares--a case control study.

Author information

1
Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
2
Department of Rheumatology, Dongfang Hospital, The Second Clinical Medical College of Beijing University of Chinese Medicine, Beijing, China.

Abstract

OBJECTIVE:

To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL).

METHODS:

Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome.

RESULTS:

PRL cases were divided into active (a-PRL) (n = 82, 53.0%) and stable lupus (s-PRL) (n = 73, 47.0%). Compared with nonpregnant active female systemic lupus erythematosus (SLE) patients, a-PRL including new-onset lupus (n-PRL) and flare lupus (f-PRL) (n = 41 respectively), had a higher incidence of renal and hematological involvement but less mucocutaneous and musculoskeletal involvement (p<0.05). The incidence of preeclampsia/eclampsia, fetal loss, and preterm birth were significantly higher in a-PRL than in s-PRL (p<0.05). Despite receiving a more vigorous glucocorticoid treatment, a-PRL mothers had a poorer prognosis (p<0.001). Five (6.1%) of them died and 13 (15.9%) developed severe irreversible organ failure, whereas none of these events was observed in the s-PRL group. Multivariate logistic analysis indicated that a history of lupus flares and serological activity (hypocomplementemia and/or anti-dsDNA positivity) at the time of conception were associated with lupus flares in PRL mothers.

CONCLUSIONS:

SLE patients with a flare history and serological activity at the time of conception were at an increased risk of disease flares during pregnancy and puerperium. a-PRL patients were more prone to renal and hematological involvement, pregnancy complications, and a poorer prognosis despite more vigorous glucocorticoid treatment.

PMID:
25118692
PMCID:
PMC4131906
DOI:
10.1371/journal.pone.0104375
[Indexed for MEDLINE]
Free PMC Article

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