2014
DOI: 10.1371/journal.pone.0104375
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Pregnancy-Related Systemic Lupus Erythematosus: Clinical Features, Outcome and Risk Factors of Disease Flares — A Case Control Study

Abstract: ObjectiveTo investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL).MethodsMedical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome.ResultsPRL cases were divided into active (a-PRL) (n = 82, 53.0%) and stable lupus (s-PRL) (n = 73, 47.0%). Compared with nonpregnant active female systemic lupus erythematosus (SLE) pa… Show more

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Cited by 62 publications
(64 citation statements)
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“…Increased risk for (i) maternal disease activity (RR 2.1 for subsequent flare during pregnancy and puerperium); 14 (ii) hypertensive complications (OR 1.8 for PE); 15 (iii) fetal morbidity and mortality (OR 5.7 for pregnancy loss, 16 3.5 for IUGR 17 6.5 for preterm delivery) 14 15 17-22 Lupus nephritis (history or active at conception †)…”
Section: Disease-related Risk Factorsmentioning
confidence: 99%
“…Increased risk for (i) maternal disease activity (RR 2.1 for subsequent flare during pregnancy and puerperium); 14 (ii) hypertensive complications (OR 1.8 for PE); 15 (iii) fetal morbidity and mortality (OR 5.7 for pregnancy loss, 16 3.5 for IUGR 17 6.5 for preterm delivery) 14 15 17-22 Lupus nephritis (history or active at conception †)…”
Section: Disease-related Risk Factorsmentioning
confidence: 99%
“…In fact, active SLE during the pregestation period is associated with increased risk of flare during pregnancy and particular attention should be given to the type of organ involvement, as active organ involvement in the 6 months before conception predicts the same involvement during pregnancy, especially for renal, haematological and skin activity [15e18, 20,30e40]. Moreover, SLE activity before and during pregnancy also predicts damage accrual [36,41]. Present or past history of LN should be regarded as a 'red flag' for pregnancy as the worst maternal outcomes have been observed in these patients.…”
Section: Maternal and Foetal Outcome In Sle Pregnancymentioning
confidence: 99%
“…The EULAR recommendations for women's health and the management of family planning/pregnancy in SLE and/or APS women [46] have proposed a useful 'check-list' of factors to be considered for preconception counselling and risk stratification (synthesized and adapted in Table 1). Disease-related risk factors for unfavourable maternal/foetal outcome include increased SLE activity or flares at conception or in the 6e12 months before [15,17,25,36] and serological activity (serum C3/C4, increased anti-dsDNA titres) [34,36,47,48]. Moreover, some 'critical' clinical and serological phenotypes of SLE patients have to be considered at increased risk for complications and should deserve a particular management and follow-up during pregnancy and the post-partum period: -patients with past or present history of LN -patients with anti-Ro/SSA and/or anti-La/SSB antibodies positivity -patients with aPL positivity or SLE associated APS The main issues related to these subgroups of SLE patients will be discussed in the next paragraphs (number 3,4, and 5).…”
Section: Preconception Counselling and Pregnancy Monitoringmentioning
confidence: 99%
“…In contrast, pregnancy may be associated with disease flares in patients with systemic lupus erythematosus (SLE). Pregnant patients with SLE have a higher incidence of renal and hematological involvement but decreased mucocutaneous and musculoskeletal involvement compared to non-pregnant patients with SLE [4]. Because immune-mediated cytopenias primarily affect women of childbearing age, it is not uncommon for immune cytopenias including immune thrombocytopenia (ITP), thrombotic thrombocytopenia purpura (TTP), autoimmune hemolytic anemia (AIHA), and autoimmune neutropenia (AIN) to complicate pregnancy.…”
Section: Introductionmentioning
confidence: 99%