medigraphic.com
ISSN 1817-5996 (Electronic)

2013, Number 2

<< Back Next >>

Rev Cub de Reu 2013; 15 (2)

Pregnancy and puerperium in patients with systemic lupus erythematosus. Update

Guibert TZM, Reyes LGA, Rigñack RL, Cruz GY, Acosta LD, Salgado GSB

Language: Spanish
References: 39
Page:
PDF size: 125.04 Kb.


ABSTRACT

Systemic lupus erythematosus is known to occur predominantly in women and in their childbearing years. When pregnancy occurs, an increased exposure to oestrogens is expected. Given the known deleterious effects of exposure to oestrogens in systemic lupus erythematosus, pregnancy would reasonably be expected to have an overall negative impact on its course and progression. The impact of pregnancy on lupus disease has been investigated but remains controversial, especially with regard to the incidence of disease y exacerbations during gestation. In contrast, the impact of systemic lupus erythematosus on pregnancy is more clearly understood. Women with lupus disease are not less fertile than unaffected women, but fetal outcome in lupus pregnancy is characterized by higher rates of fetal loss, preterm delivery and intrauterine growth restriction. Post-partum damage accrual significantly increased after pregnancy. It is very important to take into account the role that some features have in systemic lupus erythematosus and pregnancy: disease management, family planning counselling and appropriate patient education in order to prevent the thoroughly described adverse maternal and fetal outcomes pregnant lupus patients may experience.


REFERENCES

  1. Cutolo M, Wilder RL. Different roles for androgens and estrogens in the susceptibility to autoimmune rheumatic diseases. Rheum Dis Clin North Am. 2000;26:825-39.

  2. Wilder RL, Elenkov IJ. Hormonal regulation of tumor necrosis factor-alpha, interleukin-12 and interleukin-10 production by activated macrophages. A disease-modifying mechanism in rheumatoid arthritis and systemic lupus erythematosus? Ann N Y Acad Sci. 1999;876:14-31.

  3. Wilder RL. Hormones, pregnancy, and autoimmune diseases. Ann N Y Acad Sci. 1998;840:45-50.

  4. Hochberg M. c, Silman AJ, Smolen JS Weinblatt ME, Weisman MH. RHEUMATOLOGY FIFTH ED. 2011; vol.2.

  5. R. M. Andrade, G. McGwin Jr, G. S. Alarcón, M. L. Sanchez, A. M. Bertoli, M. Fernández, B. J. Fessler, M. Apte, A. M. Arango, H. M. Bastian, L. M. Vilá and J. D. Reveille4 for the LUMINA Study Group Predictors of post-partum damage accrual in systemic lupus erythematosus: data from LUMINA, a multiethnic US cohort (XXXVIII) Rheumatology.2006; 45 (11): 1380-84.

  6. Ruiz-Irastorza G, Lima F, Alves J, Khamashta MA, Simpson J, Hughes GRV, Buchanan NMM. Increased rate of lupus flare during pregnancy and the puerperium: a prospective study of 78 pregnancies. Br J Rheumatol. 1996; 35:133-8.

  7. Lockshin MD, Samaritano LR. Lupus pregnancy. Autoimmunity. 2003; 36:33-40.

  8. Bramham K, Soh MC, Nelson-Piercy C. Pregnancy and renal outcomes in lupus nephritis: an update and guide to management. Lupus. 2012; 21(12):1271-83.

  9. Uehara N, Hashimoto H, Shiokawa Y, Takeuchi H, Kino H. Clinical study on systemic lupus erythematosus with pregnancy. Clin Immunol. 1980; 12:645–54.

  10. Hayslett JP, Lynn RI. Effect of pregnancy in patients with lupus nephropathy. Kidney Int1980; 18:207–20.

  11. Fine LG, Barnett EV, Danovitch GM et al. Systemic lupus erythematosus in pregnancy. Ann Intern Med. 1981; 142:771–6.

  12. Imbasciati E, Surian M, Bottino S et al. Lupus nephropathy and pregnancy. Nephron1984; 36:46–51.

  13. Lima F, Buchanan N, Khamashta M, Kerslake S, Hughes G. Obstetric outcome in systemic lupus erythematosus. Semin Arthritis Rheum.1995; 25:184–92.

  14. J Cortés Hernández, OrdiRos, F. Paredes, M. Casellas, F. Castillo and M. Vilardell‐Tarres. Clinical predictors of fetal and maternal outcome in systemic lupus erythematosus: a prospective study of 103 pregnancies Rheumatology.2002; 41 (6): 643-50.

  15. M. Y. Karim, C. N. Pisoni, and M. A. Khamashta Update on immunotherapy for systemic lupus erythematosus—what's hot and what's not! Rheumatology; (2009) 48 (4): 332-341.

  16. Petri M, Howard D, Repke J. Frequency of lupus flares in pregnancy: the Hopkins Lupus Pregnancy Center experience. Arthritis Rheum. 1991; 34:1538– 45.

  17. Zulman JC, Talal N, Hoffman GS, Epstein WV. Problems associated with the management of pregnancies in patients with systemic lupus erythematosus. J Rheumatol. 1980;7:37–49.

  18. Derksen RHWM, Bruinse HW, Groot PG, Kater L. Pregnancy in systemic lupus erythematosus: a prospective study. Lupus. 1994; 3:149–55.

  19. Khamashta MA, Ruiz‐Irastorza G, Hughes GR. Systemic lupus erythematosus flares during pregnancy. Rheum Dis Clin North Am. 1997; 23:15–30.

  20. Georgiou PE, Politi EN, Katsimbri P, Sakka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatology. 2000; 39:1014–9.

  21. The Canadian Hydroxychloroquine Study Group. A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus. N Engl J Med. 1991; 324:150–4.

  22. Ostensen M, Clowse M. Pathogenesis of pregnancy complications in systemic lupus erythematosus. Curr Opin Rheumatol 2013; Curr Opin Rheumatol. 2013; 25(5):591-6.

  23. Rebecca Fischer-Betz, Christof Specker, Ralph Brinks, Martin Aringer, and Matthias Schneider. Low risk of renal flares and negative outcomes in women with lupus nephritis conceiving after switching from mycophenolate mofetil to azathioprine Rheumatology.2013;52 (6): 1070-1076.

  24. R. Perricone, C. De Carolis, B. Kröegle, E. Greco, R. Giacomelli, P. Cipriani, L. Fontana and C. Perricone. Intravenous immunoglobulin therapy in pregnant patients affected with systemic lupus erythematosus and recurrent spontaneous abortion Rheumatology.2008;47 (5): 646-651.

  25. Maria J. Cuadrado, Maria L. Bertolaccini, Paul T. Seed, Maria G. Tektonidou, Angeles Aguirre, Luisa Mico et al. Low-dose aspirin vs low-dose aspirin plus low-intensity warfarin in thromboprophylaxis: a prospective, multicentre, randomized, open, controlled trial in patients positive for antiphospholipid antibodies (ALIWAPAS). rheumatology/ket313. 2013; 10-1093.

  26. Urowitz MB, Gladman DD, Farewell VT, Stewart J, McDonald J. Lupus and pregnancy studies. Arthritis Rheum. 1993; 36:1392-7.

  27. Mintz G, Niz J, Gutierrez G, Garcia-Alonso A, Karchmer S. Prospective study of pregnancy in systemic lupus erythematosus. Results of a multidisciplinary approach. J Rheumatol. 1986; 13:732-9.

  28. Clowse ME, Magder LS, Witter F, Petri M. The impact of increased lupus activity on obstetric outcomes. Arthritis Rheum. 2005;52:514-21.

  29. Georgiou PE, Politi EN, Katsimbri P, Sakka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatol. 2000; 39:1014-9.

  30. Petri M. Systemic lupus erythematosus and pregnancy. Rheum Dis Clin North Am1994;20:87–118.

  31. Ruiz‐Irastorza G, Lima F, Alves J et al. Increased rate of lupus flare during pregnancy and the puerperium. Br J Rheumatol. 1996; 35:133–8.

  32. Wong KL, Chan FY, Lee CP. Outcome of pregnancy in patients with systemic lupus erythematosus. Arch Intern Med. 1991;151:269–73.

  33. Lockshin MD, Reinitz E, Druzin MS et al. Lupus pregnancy: I. Case–control prospective study demonstrating absence of lupus exacerbation during or after pregnancy. Am J Med. 1984;77:893–8.

  34. Meehan RT, Dorsey JK. Pregnancy among patients with systemic lupus erythematosus receiving immunosuppressive therapy. J Rheumatol. 1987;14:252– 8.

  35. Carmona F, Font J, Cervera R, Muñoz F, Cararach V, Balasch J. Obstetrical outcome of pregnancy in patients with systemic lupus erythematosus. A study of 60 cases. Eur J Obstet Gynecol. 1999; 83:137–42.

  36. Alarcón GS, Friedman AW, Straaton KV, et al. Systemic lupus erythematosus in three ethnic groups: III. A comparison of characteristics early in the natural history of the LUMINA cohort. LUpus in MInority populations: NAture vs. Nurture. Lupus. 1999;8:197-209.

  37. Gil A. Reyes Llerena; Marlene Guibert Toledano; Raúl Vasallo Prieto; Ana Marta López Mantecón; Ida Rosa López Aguilera; Iván Delgado Ferreiro. Rev Cubana Obstet Ginecol. 2009; (35):4.

  38. Guibert Toledano Zoila Marlene, Reyes Llerena Gil A., Gil Armenteros R, Prada Hernández D M. Hernández Cuéllar IM. Lupus y embarazo en adolescents, Libro de Reumatología pediátrica, 2013.

  39. Ateka-Barrutia O, Khamashta M. The challenge of pregnancy for patients with SLE. Lupus. 2013;22(12):1295-1308.




2020     |     www.medigraphic.com