Characterization of pregnant women with systemic lupus erythematosus and maternofetal outcomes in Northwestern Colombia: A descriptive study
DOI:
https://doi.org/10.17533/udea.iatreia.25Keywords:
pregnancy, pregnancy outcome, lupus erythematosus systemicAbstract
Objective: To evaluate the epidemiological, clinical and therapeutic characteristics of pregnant women with systemic lupus erythematosus, as well as their obstetric results, in two reference centers in northwestern Colombia.
Methods: Retrospective case series that evaluated the pregnant women seen in the Maternal-Fetal Medicine and Rheumatology Units between 2010 and 2015.
Results: 40 patients and 43 pregnancies were included. The average age at diagnosis: 24 ± 7 years; 22 (55 %) were primigravidae. The most common clinical affectation was articular (n = 32, 80 %). Eight of 43 pregnancies (18.6 %) presented lupus activity at the beginning of gestation. The most frequent obstetric complication was preeclampsia in 11/43 (25.6 %) pregnancies. The most common fetal complication was preterm labor (8/43, 18.6 %). Anticardiolipin and anti-DNA antibodies were positive in 10/43 (23.3%) and in 15/38 (39.5 %) pregnancies, respectively. In 13 gestations (31.7 %), there were relapses during the third trimester, and of these, in six cases (46.1 %) there were severe especially nephritis. On admission, prednisone was used in 29/43 (65 %) pregnancies and antimalarial drugs in 32/43 (74.4 %). In the puerperium, two patients had a moderate relapse and two mothers had preeclampsia. No maternal deaths were found and perinatal survival was 86% (37/43 pregnancies).
Discussion: In this cohort of patients with systemic lupus erythematosus and pregnancy, nephritis and antiphospholipid antibodies were present in a large part of the patients with obstetric complications, although a low percentage of patients were active before gestation; maternal and fetal complications were frequent.
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