Comparativa de resultados obstétricos en pacientes con lupus eritematoso sistémico (LES) y enfermedad indiferenciada del tejido conectivo (UCTD): un estudio de cohorte descriptivo

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
C. Muñoz Muñoz , F. Farinha , T. McDonnell , H. Jbari , H. Nguyen , D. Isenberg , A. Rahman , D. Williams , J. Alijotas-Reig , I. Giles
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引用次数: 0

Abstract

Background

Females diagnosed with systemic lupus erythematosus (SLE) face an elevated risk of adverse pregnancy outcomes (APOs). However, the evidence regarding whether a similar association exists in patients with undifferentiated connective tissue disease (UCTD) is inconclusive.

Methods

We conducted a retrospective review (2006-2019) of pregnancy outcomes among patients with SLE (n = 51) and UCTD (n = 20) within our institution. We examined the occurrence of various APOs, encompassing miscarriage, stillbirth, termination, preterm birth, pre-eclampsia, eclampsia, HELLP syndrome, intrauterine growth restriction, abruption placentae, congenital heart block, or other cardiac abnormalities.

Results

The mean age at pregnancy was 35 ± 7.0 years for patients with SLE and 35 ± 6.8 years for those with UCTD (P = .349). The proportion of Caucasian women was 47% in SLE and 80% in UCTD. Pregnancies in both groups were planned (81% in SLE and 77% in UCTD), and patients presented with inactive disease at conception (96% in SLE and 89% in UCTD). Hydroxychloroquine at conception was utilized by 86% of women with SLE, in contrast to 36% in the UCTD group. Both, SLE and UCTD cohorts exhibited low rates of disease flares during pregnancy and/or puerperium (14% vs. 10%). The incidence of APOs was 15.6% in SLE patients compared to 5% in those with UCTD (Risk difference 19.5%; 95% confidence interval: −3.9 to 43.1; P = .4237).

Conclusion

Our study underscores the importance of strategic pregnancy planning and the maintenance of appropriate treatment throughout pregnancy to ensure optimal disease management and minimize adverse outcomes in both SLE and UCTD pregnancies.

系统性红斑狼疮(SLE)和未分化结缔组织病(UCTD)患者的产科结果比较:一项描述性队列研究
背景被诊断患有系统性红斑狼疮(SLE)的女性面临不良妊娠结局(APO)的风险升高。方法我们对本机构的系统性红斑狼疮患者(51 人)和未分化结缔组织病患者(20 人)的妊娠结局进行了回顾性研究(2006-2019 年)。结果系统性红斑狼疮患者的平均妊娠年龄为 35 ± 7.0 岁,而 UCTD 患者的平均妊娠年龄为 35 ± 6.8 岁(P = .349)。系统性红斑狼疮患者中白种女性的比例为 47%,而 UCTD 患者中白种女性的比例为 80%。两组患者均为计划内怀孕(系统性红斑狼疮患者为 81%,系统性红斑狼疮合并症患者为 77%),患者在受孕时疾病并不活跃(系统性红斑狼疮患者为 96%,系统性红斑狼疮合并症患者为 89%)。86%的系统性红斑狼疮妇女在受孕时使用了羟氯喹,而 UCTD 组中只有 36% 的妇女在受孕时使用了羟氯喹。在妊娠期和/或产褥期,系统性红斑狼疮组和尿毒症组的疾病复发率都很低(14% 对 10%)。我们的研究强调了妊娠期战略规划和在整个妊娠期保持适当治疗的重要性,以确保对系统性红斑狼疮和 UCTD 患者的疾病进行最佳管理,并尽量减少不良后果。
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来源期刊
Revista clinica espanola
Revista clinica espanola 医学-医学:内科
CiteScore
4.40
自引率
6.90%
发文量
73
审稿时长
28 days
期刊介绍: Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI). The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Nine issues are published each year, including mostly originals, reviews and consensus documents.
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