Document Detail


The effect of lupus nephritis on pregnancy outcome and fetal and maternal complications.
MedLine Citation:
PMID:  20231194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effect of lupus nephritis on pregnancy with respect to fetal outcome, maternal complications, and lupus activity. METHODS: All pregnancies seen between 1970 and 2003 in the Lupus Clinic were evaluated for the 3 outcomes. Renal disease was defined as the presence of nephrotic syndrome, dialysis, renal transplant, serum creatinine > 120 mmol/l, proteinuria, sterile hematuria and pyuria, or the presence of casts. Fetal complications were evaluated in pregnancies resulting in either live births or stillbirths. Generalized estimating equations were used to test for differences in outcomes between pregnancies with and without the presence of active renal disease. Repeated measures adjustments were made in the model for multiple pregnancies in the same mother. RESULTS: There were 193 pregnancies in 104 women. Of these, 81 occurred in the presence of active renal disease during the study period, defined as 6 months prior to conception until the date of pregnancy outcome. One hundred twelve pregnancies were defined as nonrenal. No statistical difference was found in pregnancy outcome. Fetal complications were not different between the 2 groups with the exception of low birth weight and congenital malformations, which were observed more frequently in the renal group. Pregnancy-induced hypertension was more frequent in pregnancies with renal disease. Lupus flares were also more likely to occur in pregnancies with renal disease compared to those without. CONCLUSION: Lupus nephritis in pregnancy does not lead to worsened pregnancy or fetal outcomes. Active renal disease, however, is associated with pregnancy-induced hypertension, as well as a flare of lupus activity during pregnancy.
Authors:
Dafna D Gladman; Anu Tandon; Dominique Iba?ez; Murray B Urowitz
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Publication Detail:
Type:  Journal Article     Date:  2010-03-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  37     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  754-8     Citation Subset:  IM    
Affiliation:
University of Toronto Lupus Clinic, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, Ontario, Canada. dafna.gladman@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Female
Humans
Infant, Newborn
Lupus Nephritis / diagnosis,  physiopathology*
Maternal-Fetal Exchange
Pregnancy
Pregnancy Complications / diagnosis,  physiopathology*
Pregnancy Outcome
Prospective Studies
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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