{"title":"[系统性红斑狼疮患者不良妊娠结局的预测因素]。","authors":"W Wang, Y Hou, C Li, X Zhang","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To identify predictors of adverse pregnancy outcomes (APOs) in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 318 SLE patients who delivered at Peking University People' s Hospital from May 2016 to September 2021. These patients were categorized into two groups The APOs group (<i>n</i>=85) and the non-APOs group (<i>n</i>=233). Various factors, including disease duration, clinical manifestations, laboratory parameters, and systemic lupus erythematosus disease activity index 2000 (SLEDAI-2000) scores, were analyzed for their association with APOs. SPSS 26.0 software was used to analyze the data.</p><p><strong>Results: </strong>The mean age of SLE patients in this study was (24.65±5.26) years. Among the 318 pregnancies studied, 302 (302/318, 94.97%) resulted in live births, while 16 (16/318, 5.03%) cases ended in stillbirths, with no neonatal deaths reported. Among the live births, 206 (206/302, 68.21%) were full-term infants, 65 (65/302, 21.52%) cases were small for gestational age (SGA), and 31 (31/302, 10.26%) cases were preterm. The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group (5.82±4.97 <i>vs.</i> 3.74±3.72, <i>t</i>=4.019, <i>P</i>=0.001), suggesting greater disease activity as a risk factor. Similarly, glucocorticoid doses were markedly higher in the APOs group [12.50 (7.50, 50.00) mg <i>vs.</i> 10.00 (5.00, 15.00) mg, <i>P</i> < 0.001], underscoring the link between disease severity and APOs. Univariate analysis revealed that lupus nephritis (31.76% <i>vs</i>. 21.03%, <i>χ</i><sup>2</sup>=3.946, <i>P</i>=0.047), thrombocytopenia (24.71% <i>vs</i>. 9.01%, <i>χ</i><sup>2</sup>=13.380, <i>P</i> < 0.001), hypocomplementemia (36.47% <i>vs</i>. 26.03%, <i>χ</i><sup>2</sup>=4.847, <i>P</i>=0.028), antiphospholipid antibody positivity (20.00% <i>vs.</i> 11.16%, <i>χ</i><sup>2</sup>=4.163, <i>P</i>=0.041), and absence of pregnancy treatment (21.18% <i>vs</i>. 11.59%, <i>χ</i><sup>2</sup>=4.713, <i>P</i>=0.030) were associated with increased APOs risk. Multivariate Logistic regression identified thrombocytopenia (<i>OR</i>=2.671, 95%<i>CI</i> 1.309-5.449, <i>P</i>=0.007), hypocomplementemia (<i>OR</i>=1.935, 95%<i>CI</i> 1.104-3.393, <i>P</i>=0.021), and antiphospholipid antibody positivity (<i>OR</i>=2.153, 95%<i>CI</i> 1.054-4.399, <i>P</i>=0.035) as independent predictors of APOs.</p><p><strong>Conclusion: </strong>These findings highlight that certain clinical and laboratory features, including thrombocytopenia, hypocomplementemia, and antiphospholipid antibody positivity, are critical independent predictors of APOs in SLE patients. The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 3","pages":"599-603"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171608/pdf/","citationCount":"0","resultStr":"{\"title\":\"[Predictors of adverse pregnancy outcomes in patients with systemic lupus erythematosus].\",\"authors\":\"W Wang, Y Hou, C Li, X Zhang\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To identify predictors of adverse pregnancy outcomes (APOs) in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 318 SLE patients who delivered at Peking University People' s Hospital from May 2016 to September 2021. These patients were categorized into two groups The APOs group (<i>n</i>=85) and the non-APOs group (<i>n</i>=233). Various factors, including disease duration, clinical manifestations, laboratory parameters, and systemic lupus erythematosus disease activity index 2000 (SLEDAI-2000) scores, were analyzed for their association with APOs. SPSS 26.0 software was used to analyze the data.</p><p><strong>Results: </strong>The mean age of SLE patients in this study was (24.65±5.26) years. Among the 318 pregnancies studied, 302 (302/318, 94.97%) resulted in live births, while 16 (16/318, 5.03%) cases ended in stillbirths, with no neonatal deaths reported. Among the live births, 206 (206/302, 68.21%) were full-term infants, 65 (65/302, 21.52%) cases were small for gestational age (SGA), and 31 (31/302, 10.26%) cases were preterm. The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group (5.82±4.97 <i>vs.</i> 3.74±3.72, <i>t</i>=4.019, <i>P</i>=0.001), suggesting greater disease activity as a risk factor. Similarly, glucocorticoid doses were markedly higher in the APOs group [12.50 (7.50, 50.00) mg <i>vs.</i> 10.00 (5.00, 15.00) mg, <i>P</i> < 0.001], underscoring the link between disease severity and APOs. Univariate analysis revealed that lupus nephritis (31.76% <i>vs</i>. 21.03%, <i>χ</i><sup>2</sup>=3.946, <i>P</i>=0.047), thrombocytopenia (24.71% <i>vs</i>. 9.01%, <i>χ</i><sup>2</sup>=13.380, <i>P</i> < 0.001), hypocomplementemia (36.47% <i>vs</i>. 26.03%, <i>χ</i><sup>2</sup>=4.847, <i>P</i>=0.028), antiphospholipid antibody positivity (20.00% <i>vs.</i> 11.16%, <i>χ</i><sup>2</sup>=4.163, <i>P</i>=0.041), and absence of pregnancy treatment (21.18% <i>vs</i>. 11.59%, <i>χ</i><sup>2</sup>=4.713, <i>P</i>=0.030) were associated with increased APOs risk. Multivariate Logistic regression identified thrombocytopenia (<i>OR</i>=2.671, 95%<i>CI</i> 1.309-5.449, <i>P</i>=0.007), hypocomplementemia (<i>OR</i>=1.935, 95%<i>CI</i> 1.104-3.393, <i>P</i>=0.021), and antiphospholipid antibody positivity (<i>OR</i>=2.153, 95%<i>CI</i> 1.054-4.399, <i>P</i>=0.035) as independent predictors of APOs.</p><p><strong>Conclusion: </strong>These findings highlight that certain clinical and laboratory features, including thrombocytopenia, hypocomplementemia, and antiphospholipid antibody positivity, are critical independent predictors of APOs in SLE patients. The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.</p>\",\"PeriodicalId\":8790,\"journal\":{\"name\":\"北京大学学报（医学版）\",\"volume\":\"57 3\",\"pages\":\"599-603\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171608/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"北京大学学报（医学版）\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"北京大学学报（医学版）","FirstCategoryId":"3","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨系统性红斑狼疮（SLE）患者不良妊娠结局（APOs）的预测因素。方法：对2016年5月至2021年9月在北京大学人民医院分娩的318例SLE患者进行回顾性分析。将这些患者分为两组：APOs组（n=85）和非APOs组（n=233）。分析病程、临床表现、实验室参数、系统性红斑狼疮疾病活动指数2000 （SLEDAI-2000）评分等因素与APOs的关系。采用SPSS 26.0软件对数据进行分析。结果：本组SLE患者的平均年龄为（24.65±5.26）岁。在研究的318例妊娠中，302例（302/318,94.97%）为活产，16例（16/318,5.03%）为死产，无新生儿死亡报告。其中足月儿206例（206/302,68.21%），小胎龄儿65例（65/302,21.52%），早产儿31例（31/302,10.26%）。APOs组的SLEDAI-2000评分明显高于非APOs组（5.82±4.97比3.74±3.72,t=4.019， P=0.001），提示疾病活动性更大是一个危险因素。同样，apo组的糖皮质激素剂量明显更高[12.50 (7.50,50.00)mg vs. 10.00 (5.00, 15.00) mg, P < 0.001]，强调了疾病严重程度与apo之间的联系。单因素分析显示，红斑性肾炎（31.76%比21.03%,χ2=3.946， P=0.047）、血小板减少（24.71%比9.01%,χ2=13.380, P < 0.001）、低补体血症（36.47%比26.03%,χ2=4.847， P=0.028）、抗磷脂抗体阳性（20.00%比11.16%,χ2=4.163， P=0.041）、未接受妊娠治疗（21.18%比11.59%,χ2=4.713， P=0.030）与APOs风险增加相关。多因素Logistic回归发现血小板减少症（OR=2.671, 95%CI 1.304 -5.449， P=0.007）、低补体血症（OR=1.935, 95%CI 1.104-3.393， P=0.021）和抗磷脂抗体阳性（OR=2.153, 95%CI 1.054-4.399， P=0.035）是APOs的独立预测因子。结论：这些发现强调了某些临床和实验室特征，包括血小板减少症、低补体血症和抗磷脂抗体阳性，是SLE患者apo的关键独立预测因素。该研究强调了密切监测和主动管理这些危险因素对改善SLE患者妊娠结局的重要性。
[Predictors of adverse pregnancy outcomes in patients with systemic lupus erythematosus].
Objective: To identify predictors of adverse pregnancy outcomes (APOs) in patients with systemic lupus erythematosus (SLE).
Methods: A retrospective analysis was conducted on 318 SLE patients who delivered at Peking University People' s Hospital from May 2016 to September 2021. These patients were categorized into two groups The APOs group (n=85) and the non-APOs group (n=233). Various factors, including disease duration, clinical manifestations, laboratory parameters, and systemic lupus erythematosus disease activity index 2000 (SLEDAI-2000) scores, were analyzed for their association with APOs. SPSS 26.0 software was used to analyze the data.
Results: The mean age of SLE patients in this study was (24.65±5.26) years. Among the 318 pregnancies studied, 302 (302/318, 94.97%) resulted in live births, while 16 (16/318, 5.03%) cases ended in stillbirths, with no neonatal deaths reported. Among the live births, 206 (206/302, 68.21%) were full-term infants, 65 (65/302, 21.52%) cases were small for gestational age (SGA), and 31 (31/302, 10.26%) cases were preterm. The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group (5.82±4.97 vs. 3.74±3.72, t=4.019, P=0.001), suggesting greater disease activity as a risk factor. Similarly, glucocorticoid doses were markedly higher in the APOs group [12.50 (7.50, 50.00) mg vs. 10.00 (5.00, 15.00) mg, P < 0.001], underscoring the link between disease severity and APOs. Univariate analysis revealed that lupus nephritis (31.76% vs. 21.03%, χ2=3.946, P=0.047), thrombocytopenia (24.71% vs. 9.01%, χ2=13.380, P < 0.001), hypocomplementemia (36.47% vs. 26.03%, χ2=4.847, P=0.028), antiphospholipid antibody positivity (20.00% vs. 11.16%, χ2=4.163, P=0.041), and absence of pregnancy treatment (21.18% vs. 11.59%, χ2=4.713, P=0.030) were associated with increased APOs risk. Multivariate Logistic regression identified thrombocytopenia (OR=2.671, 95%CI 1.309-5.449, P=0.007), hypocomplementemia (OR=1.935, 95%CI 1.104-3.393, P=0.021), and antiphospholipid antibody positivity (OR=2.153, 95%CI 1.054-4.399, P=0.035) as independent predictors of APOs.
Conclusion: These findings highlight that certain clinical and laboratory features, including thrombocytopenia, hypocomplementemia, and antiphospholipid antibody positivity, are critical independent predictors of APOs in SLE patients. The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.
期刊介绍：
Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases.
The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.
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