Prospective Study of Pregnancy in Systemic Lupus Erythematosus. Results of a Multidisciplinary Approach

Mintz, G; Niz, José; Gutierrez, G Varela; Garcia-Alonso, Angel; Karchmer, S

doi:10.1097/00006254-198705000-00008

Cited by 32 publications

(56 citation statements)

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“…Three prospective studies have confirmed this situation and have shown that flare-ups generally occur in the first and second trimesters (10)(11)(12). Unlike the works mentioned, neuropathy occurred in third trimester in our patient.…”

Section: Discussionsupporting

confidence: 83%

Vasculitic Neuropathy in a Third Trimester Pregnant Patient with Systemic Lupus Erythematosus

et al. 2014

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Section: Discussionsupporting

confidence: 83%

Vasculitic Neuropathy in a Third Trimester Pregnant Patient with Systemic Lupus Erythematosus

et al. 2014

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“…We also analyzed pregnancy outcomes by histologic subtype in a subset of papers that correlated renal histology with maternal and/or fetal outcomes (11,13,15,16,19,22,29,31,36). Because of limited data, we grouped histologic subclasses into proliferative (classes III and IV), and nonproliferative (classes II and V) lesions.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

Smyth¹,

Oliveira²,

Lahr

et al. 2010

Clinical Journal of the American Society of Nephrology

543

437

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Background and objectives: Studies of the impact of systemic lupus erythematosus (SLE) and its pregnancy complications have yielded conflicting results. Major limitations of these studies relate to their small numbers of patients and retrospective designs. The aim of this study was to perform a systematic literature review of pregnancy outcomes in women with SLE and a meta-analysis of the association of lupus nephritis with adverse pregnancy outcomes.Design, setting, participants, & measurements: We searched electronic databases from 1980 to 2009 and reviewed papers with validity criteria. Random-effects analytical methods were used to evaluate pregnancy complications rates.Results: Thirty-seven studies with 1842 patients and 2751 pregnancies were included. Maternal complications included lupus flare (25.6%), hypertension (16.3%), nephritis (16.1%), pre-eclampsia (7.6%), and eclampsia (0.8%). The induced abortion rate was 5.9%, and when excluded, fetal complications included spontaneous abortion (16.0%), stillbirth (3.6%), neonatal deaths (2.5%), and intrauterine growth retardation (12.7%). The unsuccessful pregnancy rate was 23.4%, and the premature birth rate was 39.4%. Meta-regression analysis showed statistically significant positive associations between premature birth rate and active nephritis and increased hypertension rates in subjects with active nephritis or a history of nephritis. History of nephritis was also associated with pre-eclampsia. Anti-phospholipid antibodies were associated with hypertension, premature birth, and an increased rate of induced abortion.Conclusions: In patients with SLE, both lupus nephritis and anti-phospholipid antibodies increase the risks for maternal hypertension and premature births. The presented evidence further supports timing of pregnancy relative to SLE activity and multispecialty care of these patients.

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“…The frequency of flares during lupus pregnancies has been the subject of seven prospective comparative studies that have used nonpregnant lupus patients as controls (Table 2). Four of these studies did not identify an increased rate of flares, while three did [28,29,[32][33][34][35][36][37]. This disparity reflects variability in the severity of lupus among the patients in the study cohorts and in the criteria for defining a lupus flare.…”

Section: Lupus Flares Associated With Pregnancymentioning

confidence: 94%

“…Several prospective studies have suggested that the frequency of these flares may be lowest in the third trimester [28][29][30]. Reported rates of such flares range from 13.5-65% of pregnancies in affected women [31].…”

Section: Lupus Flares Associated With Pregnancymentioning

confidence: 99%

Flares of systemic lupus erythematosus during pregnancy and the puerperium: prevention, diagnosis and management

Stojan

Baer²

2012

Expert Review of Clinical Immunology

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Prospective Study of Pregnancy in Systemic Lupus Erythematosus. Results of a Multidisciplinary Approach

Cited by 32 publications

References 0 publications

Vasculitic Neuropathy in a Third Trimester Pregnant Patient with Systemic Lupus Erythematosus

Vasculitic Neuropathy in a Third Trimester Pregnant Patient with Systemic Lupus Erythematosus

A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

Flares of systemic lupus erythematosus during pregnancy and the puerperium: prevention, diagnosis and management

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