The role of angiogenic biomarkers and uterine artery Doppler in pregnant women with systemic lupus erythematosus or antiphospholipid syndrome

Rodriguez-Almaraz, M Esther; Herraı̀z, Ignacio; Gómez‐Arriaga, P.I.; Vallejo, P.; Gonzalo-Gil, Elena; Usategui, Alicia; López‐Jiménez, Elena; Galindo, Alberto; Galindo, M.

doi:10.1016/j.preghy.2018.01.008

Cited by 17 publications

(12 citation statements)

References 32 publications

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“…In the Predictors of Pregnancy Outcome: Biomarkers in APL Syndrome and SLE study, sFlt‐1 and PlGF levels between 12 and 15 weeks were significantly altered in patients with SLE with severe adverse obstetric outcomes (13). Another publication identified a higher sFlt‐1:PlGF ratio between 24 and 29 weeks in women with SLE who developed adverse obstetric outcomes compared to uncomplicated pregnancies and 5 patients with SLE flare, none with renal activity (14).…”

Section: Discussionmentioning

confidence: 99%

Soluble Flt‐1, Placental Growth Factor, and Vascular Endothelial Growth Factor Serum Levels to Differentiate Between Active Lupus Nephritis During Pregnancy and Preeclampsia

Jesús

Lacerda

Rodrigues

et al. 2021

Arthritis Care & Research

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Objective To evaluate mean serum levels of vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and soluble Flt‐1 (sFlt‐1) in pregnant patients with systemic lupus erythematosus (SLE) with inactive disease, active lupus nephritis, and preeclampsia for differential diagnosis between these conditions. Methods Pregnant women with SLE, with singleton pregnancies and no other autoimmune diseases, were classified according to disease activity (inactive SLE and active lupus nephritis) and the presence of preeclampsia. Serum samples were collected within 3 weeks of delivery and frozen for subsequent blinded analysis through the enzyme‐linked immunosorbent assay method. Results A total of 71 women were included, with 41 classified as having inactive SLE (group 1; Systemic Lupus Erythematosus Pregnancy Disease Activity Index [SLEPDAI] score <4), 15 with a diagnosis of active lupus nephritis (group 2, SLEPDAI score ≥4, including renal criteria), and 15 with a diagnosis of preeclampsia (group 3). Patients in group 3 had higher mean levels of sFlt‐1 and lower mean levels of PlGF compared to groups 1 and 2, both findings with statistical significance. The sFlt‐1:PlGF ratio was also significantly higher in patients with preeclampsia, while mean VEGF levels were higher in pregnant woman with active lupus nephritis compared to patients with preeclampsia or inactive SLE. Conclusion Evaluation of serum VEGF, PlGF, and sFlt‐1 levels can differentiate between preeclampsia, inactive SLE, and active lupus nephritis during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Soluble Flt‐1, Placental Growth Factor, and Vascular Endothelial Growth Factor Serum Levels to Differentiate Between Active Lupus Nephritis During Pregnancy and Preeclampsia

Jesús

Lacerda

Rodrigues

et al. 2021

Arthritis Care & Research

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“…It has also been reported that abnormalities of Doppler waves of the uterine artery are associated with preeclampsia in patients with SLE or APS. 44 We did not analyze these alterations due to a lack of studies on all our patients.…”

Section: Discussionmentioning

confidence: 99%

Use of antimalarial drugs is associated with a lower risk of preeclampsia in lupus pregnancy: A prospective cohort study

et al. 2020

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Introduction: Several factors have been associated with the development of preeclampsia in women with systemic lupus erythematosus (SLE). Objective:To identify risk factors associated with preeclampsia in patients with SLE and its impact on fetal outcomes. Patients and methods:We studied a prospective cohort of pregnancies in women with SLE from January 2009 to December 2018. Demographic, clinical, serological and drug use characteristics were compared between patients who developed preeclampsia and those who did not, as well as the main neonatal outcomes. An adjusted logistic regression analysis was performed to identify factors potentially associated with preeclampsia. Results:We studied 316 pregnancies of 20 or more weeks of gestation. A total of 46 pregnancies (14.5%) were complicated by preeclampsia. A higher frequency of active disease before pregnancy (24.4% vs 11.3%, P = .01) and history of lupus nephritis (56.5% vs 30.1%, P < .001) were found in those patients who developed preeclampsia compared to those who did not. Preeclampsia was associated with a higher rate of prematurity, births of very low birth weight, stillbirth, and neonatal death. The multivariate analysis showed that the activity of the disease before (relative risk [RR] 2.7, 95% CI 1.04-7.4, P = .04) and during pregnancy (RR 3.0, 95% CI 1.0-9.1, P = .04) was associated with the development of preeclampsia. The use of antimalarial drugs during pregnancy was associated with a lower risk of preeclampsia (RR 0.21, 95% CI 0.08-0.53, P < .001). Conclusions:Our study suggests that the use of antimalarial drugs during pregnancy reduces the risk of preeclampsia in lupus pregnancies. K E Y W O R D Santimalarials, preeclampsia, pregnancy, systemic lupus erythematosus

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“…Conversely lower levels of s-FLTt-1 and higher levels of PlGF were associated with substantially decreased risk of APO. A recent study by Rodríguez-Almaraz et al 75 , which included 44 patients with SLE and/or APS, demonstrated a correlation between high sFLTt-1/PlGF ratio as well as an increased uterine mean arterial pulsatile index in patients with an adverse obstetric outcome, such as pre-eclampsia or growth restriction, while patients with a normal pregnancy or an SLE flare did not have the same changes. More studies are needed, but early measurements of circulating angiogenic factors may become a useful tool for risk stratification in SLE and APS pregnancies.…”

Section: Oaps In Patients Diagnosed With Slementioning

confidence: 94%

Obstetric antiphospholipid syndrome

et al. 2018

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The present clinical and laboratory classification criteria for antiphospholipid syndrome (APS) were established in Sydney, Australia, in 2006. In this review, we focus on the obstetric subset of APS (OAPS), defined by persistent positivity for antiphospholipid antibodies together with either early recurrent pregnancy loss, early fetal death, stillbirth or premature birth <34 gestational weeks due to pre-eclampsia, eclampsia and placental insufficiency. It is important to diagnose these cases since most women suffering from OAPS can, when given appropriate treatment, have successful pregnancies. Furthermore, patients with OAPS may, depending on the antibody profile, be at enhanced risk of thrombotic events later in life. We present an update on the present knowledge of possible underlying pathogenesis, risk factors and risk estimations for adverse pregnancy outcomes before and during pregnancy, current treatment concepts, and long-term outcomes for women with OAPS and their children.

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The role of angiogenic biomarkers and uterine artery Doppler in pregnant women with systemic lupus erythematosus or antiphospholipid syndrome

Cited by 17 publications

References 32 publications

Soluble Flt‐1, Placental Growth Factor, and Vascular Endothelial Growth Factor Serum Levels to Differentiate Between Active Lupus Nephritis During Pregnancy and Preeclampsia

Soluble Flt‐1, Placental Growth Factor, and Vascular Endothelial Growth Factor Serum Levels to Differentiate Between Active Lupus Nephritis During Pregnancy and Preeclampsia

Use of antimalarial drugs is associated with a lower risk of preeclampsia in lupus pregnancy: A prospective cohort study

Obstetric antiphospholipid syndrome

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