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Int Urol Nephrol. 2015 Aug;47(8):1379-85. doi: 10.1007/s11255-015-1032-y. Epub 2015 Jun 24.

Clinical outcomes and predictors of fetal and maternal consequences of pregnancy in lupus nephritis patients.

Author information

1
Department of Nephrology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, No. 168 Li Tang Rd., Dongxiaokou Town, Tiantongyuan Area, Changping District, Beijing, 102218, China.

Abstract

OBJECTIVE:

To define the outcomes and risk predictors of fetal and maternal consequences of pregnancy in lupus nephritis (LN) patients.

METHODS:

Maternal and fetal outcomes of pregnancy in 52 systemic lupus erythematosus (SLE) patients were observed. Patients were allocated into two groups according to the presence or absence of LN.

RESULTS:

LN patients were subject to a higher risk of fetal complications, including fetal loss (7/24, 29.2 %, P = 0.001), lower birth weight (2548.2 ± 540.8 vs. 2949.1 ± 592.6 g, P = 0.028) and a higher frequency of small for gestational age births (33.3 vs. 10.7 %, P = 0.002). Higher rates of lupus flares (83.3 vs. 21.4 %, P = 0.001) and increased LAI-P scores (0.65 ± 0.36 vs. 0.21 ± 0.27, P = 0.001) during pregnancy were observed in LN patients. Multivariate analysis showed that increased SLE activity (P = 0.02, OR 4.2, 95 % CI 1.2-14.5), renal damage (P = 0.001, OR 8.4, 95 % CI 2.2-31.8), hypocomplementemia (P = 0.05, OR 3.23, 95 % CI 1.0-10.7), hypoalbuminemia (P = 0.011, OR 5.62, 95 % CI 1.4-23.0) and hypertension (P = 0.021, OR 6.0, 95 % CI 1.5-24.2) during pregnancy were predictors of adverse fetal outcomes.

CONCLUSIONS:

Pregnancy in LN patients should be monitored before and during pregnancy because of poor fetal and maternal outcomes. Increased LAI-P scores, renal damage, hypocomplementemia, hypoalbuminemia and hypertension are predictors of adverse fetal outcomes for SLE patients.

PMID:
26104378
DOI:
10.1007/s11255-015-1032-y
[Indexed for MEDLINE]

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