The correlation of pregnancy complications with C3/C4 levels, anti-dsDNA titers, and autoimmune target testing in gravidas with systemic lupus erythematosus

Abstract

ObjectiveThe purpose of this study was to evaluate the correlation between complement (C3 and C4) levels, anti-dsDNA titers, autoimmune target test (AITT), and pregnancy complications. MethodsNinety-three pregnancies with systemic lupus erythematosus (SLE) were analyzed retrospectively. We evaluated the course of the pregnancy and outcome, pregnancy complications, progression of SLE, maternal complications of SLE, drugs taken before and after pregnancy, neonatal outcomes, and C3/C4 levels, anti-dsDNA titers, and AITT results. SPSS ver. 14.0 was used for statistical analysis. The average and standard deviation are shown. Chi-square test and Pearson correlation test were used for statistical analysis. The significance level was set at 0.05. ResultsThe C3 level was associated with maternal leukopenia, elevated serum C-reactive protein (CRP) elevation, hematuria, hypertension, and preterm premature rupture of membranes. The C4 level was associated with maternal proteinuria, hematuria, hematologic disease, and admission to the neonatal intensive care unit. The anti-dsDNA titer was associated with elevated maternal serum CRP, oligohydramnios, and neonatal anti-Sjögren's syndrome B (La) antibody. The AITT result was related to elevated erythrocyte sedimentation rate, and 1 and 5 minute Apgar scores. ConclusionOur result show that adding the AITT to conventional C3/C4 and anti-dsDNA testing in gravidas with SLE might help antenatal care.

Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea

“…Lupus flare during pregnancy was 33.3%, which is similar to recent reports in Western countries . Most previously reported flares during pregnancy were not severe and manifested as joint, cutaneous and hematological involvement . However, all of the flares in the present study were severe on the LAI‐P scale, with renal involvement being the most common flare during pregnancy, followed by thrombocytopenia, vasculitis and serositis.…”

“…Other reports from developed Asian countries such as Japan and China reported better fetal outcomes which were comparable to Western countries . The rate of live births in lupus patients ranges from 75% to 78% according to previous retrospective studies in South Korea . The present study demonstrated a relatively more favorable outcome of 82.3% of live births compared to previous reports in South Korea, and the observed rates were similar to the live birth rates worldwide.…”