本文已被:浏览 726次 下载 675次
Received:September 16, 2020 Published Online:July 20, 2021
Received:September 16, 2020 Published Online:July 20, 2021
中文摘要: 目的探讨系统性红斑狼疮(SLE)合并妊娠对妊娠结局的影响,分析妊娠丢失(流产、死胎)及不良胎儿结局(早产或胎儿生长受限)的危险因素。方法回顾性分析2012年3月1日至2019年12月31日在广州中医药大学第一附属医院产检并分娩、病例资料完整的SLE合并妊娠的孕妇,共54例、57例次妊娠。根据SLE疾病活动指数(SLEDAI)分组,其中孕早期出现病情活动者32例孕妇34例次妊娠(活动组),病情稳定者22例孕妇23例次妊娠(非活动组)。结果活动组妊娠丢失(包括流产、死胎)、子痫前期、狼疮肾炎、不良胎儿结局的发生率分别是29.41%、35.29%、67.65%、29.41%,均高于非活动组的0、4.35%、4.35%、4.35%,差异有统计学意义(P<0.05,P<0.01)。Logistic回归分析显示,SLE患者孕早期SLEDAI评分高(OR=1.322,P=0.027)和抗SSB抗体阳性(OR=5.315,P=0.045)是妊娠丢失的独立危险因素,而狼疮肾炎(OR=29.603,P=0.011)是不良胎儿结局的独立危险因素。结论孕早期SLE病情活动增加妊娠丢失、子痫前期、狼疮肾炎、不良胎儿结局的发生率;孕早期SLE病情活动与妊娠丢失密切相关;合并狼疮肾炎与不良胎儿结局密切相关。
Abstract:Objective To explore the influences of pregnancy complicated with systemic lupus erythematosus (SLE) on pregnancy outcome and analyze the risk factors of pregnancy loss (abortion,stillbirth) and adverse fetal outcome (premature birth or fetal growth restriction).
Methods A retrospective analysis was performed on 57 pregnancies in 54 pregnant SLE women with complete data of prenatal examination and delivery from March 1,2012 to December 31,2019 in the First Affiliated Hospital of Guangzhou University of TCM.According to SLE disease activity index (SLEDAI),there were 32 active SLE pregnant women (34 pregnancies) in first-trimester(active group) and 22 stable SLE pregnant women (23 pregnancies) in first-trimester(inactive group).
Results The incidences of pregnancy loss (including abortion,stillbirth),preeclampsia,lupus nephritis and adverse fetal outcome were 29.41%,35.29%,67.65% and 29.41%,respectively in active group and were significantly higher than those (0%,4.35%,4.35% and 4.35%,respectively) in inactive group(P<0.05,P<0.01).Logistic regression analysis showed that higher SLEDAI score in first-trimester(OR=1.322,P=0.027) and positive anti-SSB antibody(OR=5.315,P=0.045) were the independent risk factors for pregnancy loss,and lupus nephritis (OR=29.603,P=0.011) was an independent risk factor for adverse fetal outcome.
Conclusions SLE disease activity in early pregnant women can increase the incidences of pregnancy loss,preeclampsia,lupus nephritis and adverse fetal outcome,and is closely related to pregnancy loss.Lupus nephritis is closely related to adverse fetal outcome.
文章编号: 中图分类号:R714.259 文献标志码:B
基金项目:
引用文本: