Pre-conception status, obstetric outcome and use of medications during pregnancy of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) in Japan: Multi-center retrospective descriptive study

Tsuda, S.; Sameshima, Azusa; Sekine, Michikazu; Kawaguchi, Haruna; Fujita, Daisuke; Makino, Shintaro; Morinobu, Akio; Murakawa, Yohko; Sugiyama, Takao; Watanabe, Mamoru; Suzuki, Yasuo; Nagahori, Masakazu; Murashima, Atsuko; Atsumi, Tatsuya; Oku, Kenji; Mitsuda, Nobuaki; Takei, Syuji; Miyamae, Takako; Takahashi, Naoto; Nakajima, Ken; Saito, Shigeru

doi:10.1080/14397595.2019.1661592

Cited by 22 publications

(23 citation statements)

References 52 publications

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“…Studies in Asia were mainly from East Asia, namely Chinese, 13–15 Korean 16,17 and Japanese. 18 The influence of different ancestries in the pregnancy outcomes in lupus is not well studied due to lack of head-to-head comparisons. The LUMINA cohort of Hispanic, African American and Caucasian ethnicity showed higher APOs among Texan Hispanic and African American patients, but ethnicity was no longer a significant predictor of APOs in the multivariable model analysis.…”

Section: Introductionmentioning

confidence: 99%

Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia

Shaharir

Maulana

Shahril

et al. 2020

Lupus

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Background Despite the improvement in the live birth rate among patients with systemic lupus erythematosus (SLE), they are still at an increased risk of adverse pregnancy outcomes (APOs). Objective To determine the prevalence and factors associated with APOs in the multi-ethnic SLE populations in Malaysia. Methodology: This was a retrospective review of the consecutive SLE patients who attended the outpatient clinic in two major rheumatology centres from January 2016 until December 2019 with complete pre-pregnancy, antenatal and intra-partum records. APOs include pregnancy loss, prematurity, pre-eclampsia, intra-uterine growth restriction (IUGR) and maternal death. Univariate and multivariable logistic regression with generalised estimating equation (GEE) analyses were performed to determine the factors associated with APOs. Results A total of 153 patients with 240 pregnancies were included and the majority of the patients were Malay (69.9%), followed by Chinese (24.2%) and Indian (5.9%). The prevalence of APOs was 61.7% with the commonest complication being prematurity (28.3%), followed by pregnancy loss (24.6%) and pre-eclampsia (21.8%). Logistic regression model-based GEE analysis revealed that the independent predictors of APOs were active haematological system during pregnancy, pre-pregnancy active disease, Indian patients and positive lupus anticoagulant. Hydroxychloroquine use was associated with lower APOs including pre-eclampsia, prematurity and IUGR in the univariate analyses but it was no longer significant in the GEE analysis. Conclusion The prevalence of APOs was high particularly among the Indian patients. Positive lupus anticoagulant and pre-pregnancy active disease were the factors strongly associated with APOs in our multi-ethnic cohort. Hydroxychloroquine may protect against APOs but further larger studies are needed to confirm this.

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Section: Introductionmentioning

confidence: 99%

Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia

Shaharir

Maulana

Shahril

et al. 2020

Lupus

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“…Previous reports reveal that the APOs in SLE patients exceed that of the general population: SLE flare during pregnancy: 21.4%–64%, gestational hypertension: 0.99%–45%, gestational diabetes mellitus: 0%–11%, preeclampsia: 5.4%–20.2%, HELLP syndrome: 0.3%–0.66%, preterm birth: 9%–56%, spontaneous abortion: 0.4%–25%, SGA: 10%–28.5%, Apgar score less than 7 at 1 min: 1%–18% 3,4,8,19–26,28–49 We summarized the frequency of each APO in Table 5.…”

Section: Discussionmentioning

confidence: 97%

Risk of adverse pregnancy outcomes in Japanese systemic lupus erythematosus patients with prior severe organ manifestations: A single-center retrospective analysis

Nakai

Kitada

Fukui

et al. 2021

Lupus

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Background Systemic lupus erythematosus (SLE) increases the incidence of adverse pregnancy outcomes (APOs). Nevertheless, most of the data on SLE pregnancies were derived from database studies in which details of the pregnancies were unavailable, and no consensus exists on the risk of APO in patients with prior severe organ manifestations. Methods SLE patients followed by rheumatologists and gynecologists throughout pregnancy at our institute were retrospectively identified, and their data between April 2003 and December 2020 were reviewed from electronic records. We assigned patients based on the presence of prior severe organ manifestation (renal/neurological manifestation, prior treatment with methylprednisolone pulse therapy/prednisolone 1 mg/kg/day/biological or cytotoxic therapy) and compared the incidence of overall and serious APO (maternal death, pregnancy loss, preterm birth <32 weeks, birthweight <1500 g, Apgar score <7 at 5 min and birth defect). Results This study included 34 pregnancies in 32 patients; 23 pregnancies in 22 patients were classified as SLE with prior severe organ manifestation. There was no statistical difference in the incidence of overall APO between the two groups (52.2% vs 45.5%, P = 1). Among patients with prior severe organ manifestation, 17.4% had serious APO. A detailed electronic health record search revealed specific causes of APO in all pregnancies with serious APO, except the presence of prior severe organ manifestation. Conclusion The incidence of overall APO in SLE patients was not affected by prior severe organ manifestation. Although the incidence of serious APOs increased in patients with previous severe organ manifestation, there were other risk factors for poor pregnancy outcomes besides prior lupus severity. Therefore, proper management by rheumatologists and gynecologists may enable patients with prior severe organ manifestation to safely deliver healthy babies.

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“…Sve trudnice u posmatranom uzorku smatraju da su nedovoljno informisane i da je potrebno organizovati edukaciju na temu primene lekova u trudnoći. Ovaj podatak, podudara se sa rezultatima studije sprovedene u Japanu [19], gde je takođe identifikovan rizik koji donosi slaba informisanost i zdravstvena prosvećenost trudnica, kada je reč o korišćenju medikamenata u trudnoći [19]. Suplemente u trudnoći bez konsultacije sa stručnim licem koristi 5% trudnica dok 95% trudnica posluša mišljenje stručnog lica.…”

Section: Diskusijaunclassified

Information and personal experiences of pregnant women in relation to the application of drugs in pregnancy

Miletić¹,

Savić²,

Jokić³

et al. 2020

Sestrinska vizija

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Introduction: Pregnancy is a specific period of a woman's life in which she should pay special attention to her health potential. Certain health risks, such as drug abuse during pregnancy, can have fatal consequences for the outcome of pregnancy and the health of women and newborns. Drugs are classified into several categories according to their risk of harm to the fetus. The classification of the American Food and Drug Administration (FDA) is most often used, which is the purpose of drugs in the categories for pets (A, B, C, D, H). Aim: Examine the information and personal experiences of pregnant women regarding the use of drugs in pregnancy. Methods: The research was conducted in the form of cross-sectional studies. As a research instrument, a questionnaire for pregnant women was constructed, which assesses their level of information about aspects of drug use in pregnancy, as well as personal experiences. The study included a sample of 60 pregnant women, the sample was intentional, the study was conducted at the Jokić Polyclinic, in the period January-June 2020. Participation in the studies was voluntary and anonymous, the research was approved by the competent authorities of the institution. Results: The subjects in the observed sample were pregnant women aged 21 to 35 years. The majority of pregnant women are uninformed about the use of drugs during pregnancy. The most commonly used drugs in pregnancy are antibiotics. A large number of respondents believe that gynecologists and pharmacists should inform pregnant women more on this topic. Descriptive statistics methods were used in the analysis of the results. Conclusion: The results of the research indicate the need for a higher level of education on the safe use of drugs in pregnancy. It is necessary to intensify health education work in cooperation with health institutions of all levels. This need is also felt by pregnant women who feel that they do not know enough about this topic.

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Pre-conception status, obstetric outcome and use of medications during pregnancy of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) in Japan: Multi-center retrospective descriptive study

Cited by 22 publications

References 52 publications

Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia

Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia

Risk of adverse pregnancy outcomes in Japanese systemic lupus erythematosus patients with prior severe organ manifestations: A single-center retrospective analysis

Information and personal experiences of pregnant women in relation to the application of drugs in pregnancy

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