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2012, Number 4

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Rev Med Inst Mex Seguro Soc 2012; 50 (4)

Relapsing risk and obstetric-neonatal outcome in pregnacy and systemic lupus erythematosus

Álvarez-Nemegyei J, Domínguez-Vallejo S, Saavedra-Déciga ME, Marín-Ordóñez J, Ávila-Zapata F, Diego-Rodríguez N, Cervantes-Díaz MTJ

Language: Spanish
References: 37
Page: 355-361
PDF size: 48.66 Kb.


ABSTRACT

Objective: to assess the effect of pregnancy on systemic lupus erythematosus (SLE) activity, and the obstetric/neonatal outcome.
Methods: historic cohort including 24 female SLE patients who became pregnant. For every pregnant/puerperal period, the presence of lupus relapse, mean relapse, Mex-SLEDAI score and prednisone dose were compared.
Results: higher relapse risk (RR = 11.8), more relapse episodes (1.0 ± 1.3 vs. 0.02 ± 0.17), higher Mex-SLEDAI scores (2.0 ± 2.5 vs. 01 ± 0.7) and higher prednisone requirements (13.5 ± 12.6 vs. 7.2 ± 7.5 mg/day), were observed in pregnancy puerperal periods. The abortion incidence: 10.8 %, fetal death: 5.4 %, preeclampsia: 18.8 %, preterm deliveries: 18.9 %, neonatal mortality rate: 6.0 %, perinatal mortality rate: 10.5 %, LES activity associated to obstetric morbidity (83.3 % vs. 38.8 %, p = 0.005), preterm deliveries (43.6 % vs. 11.1 %), neonatal morbidity (46.7 % vs. 11.1 %, and low birth weight (25 % vs. 0).
Conclusions: lupus pregnancy resulted in higher relapse risk, and more severe LES activity. Lupus activity also worsens obstetric and neonatal outcome.



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