Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Wu, Jiayue; Ma, Jinghang; Zhang, Wei Hong; Di, Wen

doi:10.2147/tcrm.s160760

Cited by 40 publications

(39 citation statements)

References 56 publications

(70 reference statements)

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“…Women with SLE are receiving better multidisciplinary antenatal care ensuring better pregnancy outcome with the development of medicine. Nevertheless, current studies [5, 23–25] also reported that SLE was associated with APOs including pre-eclampsia, pregnancy-induced hypertension, spontaneous abortion. The present study have synthesized current published studies regarding GDM and SLE, and the results indicated that SLE with not associated with GDM.…”

Section: Discussionmentioning

confidence: 99%

Risk of gestational diabetes mellitus in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

Dong

Dai

Wang

et al. 2019

BMC Pregnancy Childbirth

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Background It is well established that the risks of insulin resistance and diabetes mellitus are elevated in systemic lupus erythematosus (SLE) patients. However, the relationship between SLE pregnancy and gestational diabetes mellitus (GDM) is still obscure. We perform the present systematic review and meta-analysis to determine the relationship between GDM and SLE pregnancy. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, relevant studies were carefully retrieved through PubMed, Cochrane library and Web of Science, China National Knowledge Infrastructure, Wanfang database and China Biology Medicine database from inception till 30 August 2018. GDM risk ratio (RR) of pregnant SLE patients versus controls was calculated to evaluate the association between GDM and SLE. Pooled RRs and 95% confidence intervals (CIs) were calculated using random effects model by R software. Results The literature retrieval identified 339 potential studies in total, and five studies containing 3432 pregnant participants with 248 GDM events were included finally. Pooled analysis found that the risk of GDM were not significant increased in SLE patients compared to controls (RR = 1.08, 95% CI = 0.49 to 2.41, Z = 0.19 and P = 0.848). Nevertheless, meta-regression identified that glucocorticoids use and anti-double stranded DNA antibodies positive of SLE patients were positively associated with the risk of GDM. Conclusions Our meta-analysis demonstrated that SLE pregnancy may not increase the risk of GDM, but the steroid use during pregnancy was associated with increased risk of GDM. Further large prospective and basic immunologic studies should be implemented for exploring the mechanism underlying glucocorticoids use and GDM. Electronic supplementary material The online version of this article (10.1186/s12884-019-2329-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Risk of gestational diabetes mellitus in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

Dong

Dai

Wang

et al. 2019

BMC Pregnancy Childbirth

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“…Among the immunologic diseases, systemic lupus erythematosus (SLE) principally affects women of childbearing age, and is the most recognized risk factor for the hypertensive disorders of pregnancy and p-AKI [ 128 , 129 , 130 , 131 ].…”

Section: The Role Of Immunologic Diseases In the Pathogenesis Of Tmentioning

confidence: 99%

Acute Kidney Injury in Pregnancy: The Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Prevention and Care of Pregnancy-Related AKI, in the Year Dedicated to Women and Kidney Diseases

Piccoli

Zakharova

Attini

et al. 2018

JCM

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Pregnancy-related acute kidney injury (pAKI), preeclampsia (PE), and the hypertensive disorders of pregnancy are closely related conditions, which are, in turn, frequently linked to pre-existing and often non-diagnosed chronic kidney disease (CKD). The current literature and research mainly underline the effects of pregnancy complications on the offspring; this review strongly emphasizes the maternal health as well. These conditions not only negatively affect pregnancy outcomes, but have a relevant effect on the future health of affected mothers and their children. Therefore, dedicated diagnostic and follow-up programs are needed, for optimizing materno-foetal health and reducing the impact of pregnancy-related problems in the mothers and in the new generations. This narrative review, performed on the occasion of the 2018 World Kidney Day dedicated to women’s health, focuses on three aspects of the problem. Firstly, the risk of AKI in the hypertensive disorders of pregnancy (the risk is the highest in developing countries; however PE is the main cause of pregnancy related AKI worldwide). Secondly, the effect of AKI and the hypertensive disorders of pregnancy on the development of CKD in the mother and offspring: long-term risks are increased; the entity and the trajectories are still unknown. Thirdly, the role of CKD in the pathogenesis of AKI and the hypertensive disorders of pregnancy: CKD is a major risk factor and the most important element in the differential diagnosis; pregnancy is a precious occasion for early diagnosis of CKD. Higher awareness on the importance of AKI in pregnancy is needed to improve short and long term outcomes in mothers and children.

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“…1,2 Preeclampsia is a complication more frequently observed in women with SLE compared with healthy women, especially in those with lupus nephritis (with a 2 to 4 times higher risk). [2][3][4][5] In retrospective, prospective or population-based studies, preeclampsia has been reported between 10% and 30% of pregnancies in SLE patients. [6][7][8][9][10][11][12][13] The importance of preeclampsia consists of the fact that it is a complication associated with high maternal and fetal morbidity and mortality, mainly in developing countries.…”

Section: Introductionmentioning

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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Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Cited by 40 publications

References 56 publications

Risk of gestational diabetes mellitus in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

Risk of gestational diabetes mellitus in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

Acute Kidney Injury in Pregnancy: The Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Prevention and Care of Pregnancy-Related AKI, in the Year Dedicated to Women and Kidney Diseases

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

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