Gestational outcomes in patients with neuropsychiatric systemic lupus erythematosus

Jesús, Guilherme Ramires de; Rodrigues, Bruna Costa; Lacerda, Marcela Ignacchiti; Santos, Flávia Cunha dos; Jesus, NR de; Klumb, Evandro Mendes; Levy, Roger A.

doi:10.1177/0961203317693929

Cited by 7 publications

(5 citation statements)

References 20 publications

(32 reference statements)

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“…The observed fetal/neonatal outcome was similar to that of our cohort with a live birth rate between 80 and 90% and comparable complications. Other published studies from Latin American countries address specific groups of patients, such as the obstetric outcome in childhood-onset SLE, 55 serum laminin-111 levels in preeclampsia and lupus, 56 as well as the gestational outcome in neuropsychiatric lupus 57 . Furthermore, a controlled clinical trial with a small number of patients showed the benefit of hydroxychloroquine on SLE activity during pregnancy 37 .…”

Section: Discussionmentioning

confidence: 99%

“…Other published studies from Latin American countries address specific groups of patients, such as the obstetric outcome in childhood-onset SLE, 55 serum laminin-111 levels in preeclampsia and lupus, 56 as well as the gestational outcome in neuropsychiatric lupus. 57 Furthermore, a controlled clinical trial with a small number of patients showed the benefit of hydroxychloroquine on SLE activity during pregnancy. 37 Finally, not all of these previous studies have identified factors associated with poor obstetric outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Systemic Lupus Erythematosus on Pregnancy

et al. 2020

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Background: Pregnancy in patients with systemic lupus erythematosus is considered a high risk one since it is associated with a higher rate of maternal-fetal complications compared with the pregnancies in healthy women. Objectives:The aim of this study was to describe the maternal-fetal outcomes in a cohort of Mexican patients with systemic lupus erythematosus and to identify risk factors associated with adverse maternal and fetal outcomes.Patients and Methods: A cohort of pregnant lupus patients was analyzed. Maternal-fetal complications were described, and clinical, biochemical, and immunological variables associated with obstetric adverse outcomes were studied. Descriptive statistics, comparison of variables using appropriate tests, and finally logistic regression analysis were performed to identify potential risk factors for adverse maternal and fetal outcomes.Results: A total of 351 pregnancies were included in a 10-year period.The most frequently observed maternal adverse outcomes were lupus flare (35%) and preeclampsia (14.5%). Active lupus before pregnancy (hazards ratio [HR], 3.7; 95% confidence interval [CI], 1.1-12.5; p = 0.003) was a predictor for these complications, whereas the use of antimalarial drugs (HR, 0.4; 95% CI, 0.2-0.7; p = 0.007) was a protective factor. The most frequent fetal adverse outcomes were preterm birth (38.1%), miscarriages (10%), and low birth weight babies (28%), and very low birth weight newborns (11%). Proteinuria in early pregnancy (HR, 7.1; 95% CI, 1.01-50.3; p = 0.04) and preeclampsia (HR, 9.3; 95% CI, 1.7-49.7; p = 0.009) were risk factors associated with these complications. Conclusions:Variables related to systemic lupus erythematosus activity predict an adverse maternal outcome, whereas proteinuria in early pregnancy and preeclampsia are associated with an adverse fetal outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of Systemic Lupus Erythematosus on Pregnancy

et al. 2020

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“…Gradient descent is usually used to adjust the weights and node thresholds of the BP neural network. e following will briefly introduce the process of training BP network by gradient descent method [18]. e input vector is…”

Section: Learning Methods Of Bp Neural Networkmentioning

confidence: 99%

[Retracted] Clinical Comparison of Preterm Birth and Spontaneous Preterm Birth in Severe Preeclampsia

Wen

Yang

2022

Contrast Media & Molecular Imaging

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Severe preeclampsia is accompanied by many complications, which is extremely harmful to pregnant women and fetuses. However, in the classification of preterm birth, it is generally divided into spontaneous preterm birth and therapeutic preterm birth, and insufficient attention has been paid to preterm birth in severe preeclampsia. This article aims to explore the clinical difference between preterm birth in severe preeclampsia and spontaneous preterm birth. In the experiment, this paper selected pregnant women who delivered and were treated in a hospital from April 2010 to April 2020 as cases. In terms of grouping, not only are they divided into severe eclampsia group (observation group 1), spontaneous preterm birth group (observation group 2), and general delivery group (control group) according to the cause of premature birth, but also according to the gestational age of severe eclampsia onset, preterm weeks, and other groups. Not only the clinical difference between severe preeclampsia preterm birth and spontaneous preterm birth was compared horizontally, but also the factors affecting the complications of preterm pregnant women, perinatal asphyxia rate, and mortality were longitudinally analyzed. The experimental results in this paper showed that there were significant differences in maternal complications and neonatal mortality between the severe preeclampsia preterm group and the spontaneous preterm group ( P < 0.05). In addition, the severe preeclampsia preterm birth group was more harmful than the spontaneous preterm birth group. The complication rate of the severe preeclampsia preterm birth group was 10% higher than that of the spontaneous preterm birth group, and the neonatal mortality rate was 2% higher.

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“…Therefore, we consider that this finding is not consistent with previous findings, probably due to lack of uniformity in the definitions, the different compositions of the cohorts, and differences in treatment regimens. 28,29 Considering these facts, pregnant SLE patients can be well-controlled based on the foundation of optimal management and medication adjustment. It should be noted, however, that currently available treatment options are largely still unstudied in this population.…”

Section: Discussionmentioning

confidence: 99%

Clinical study of factors associated with pregnancy outcomes in pregnant women with systemic lupus erythematosus in the southern China

et al. 2021

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Objectives: This study aims to estimate predicted factors for maternal and fetal outcomes in Hakka pregnant women with systemic lupus erythematosus (SLE) in the Southern China. Patients and methods: Between June 2014 and February 2020, we retrospectively analyzed the data of a total of 123 singleton pregnant women with SLE (mean age: 27.1±4.1 years; range, 19 to 39 years) who were referred to our rheumatology clinic. Demographic, clinical, and laboratory data of the patients were recorded. Adverse pregnancy outcomes (APOs) were assessed. Results: Multivariate logistic regression analysis revealed that preeclampsia was associated with the increased odds of APOs (odds ratios [OR]=9.538, 95% confidence interval [CI]: 2.055-44.271, p=0.004), premature birth (OR=14.289, 95% CI: 3.596-56.777, p<0.001) and low birth weight (OR=8.275, 95% CI: 2.117-32.345, p=0.002). Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibody positivity was the predictor of APOs (OR=2.165, 95% CI: 1.034-4.532, p=0.040), premature birth (OR=2.849, 95% CI: 1.220-6.657, p=0.016) and pregnancy loss (OR=3.004, 95% CI: 1.086-8.305, p=0.034). The use of hydroxychloroquine and prednisone was associated with the decreased odds of APOs (OR=0.412, 95% CI: 0.198-0.860, p=0.018) and pregnancy loss (OR=0.304, 95% CI: 0.111-0.831, p=0.020). Conclusion: Our study results indicate that preeclampsia, anti-dsDNA antibody positivity, and the use of hydroxychloroquine and prednisone are independent predictors of pregnancy outcomes.

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Gestational outcomes in patients with neuropsychiatric systemic lupus erythematosus

Cited by 7 publications

References 20 publications

Impact of Systemic Lupus Erythematosus on Pregnancy

Impact of Systemic Lupus Erythematosus on Pregnancy

[Retracted] Clinical Comparison of Preterm Birth and Spontaneous Preterm Birth in Severe Preeclampsia

Clinical study of factors associated with pregnancy outcomes in pregnant women with systemic lupus erythematosus in the southern China

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