Document Detail


A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis.
MedLine Citation:
PMID:  20688887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Studies of the impact of systemic lupus erythematosus (SLE) and its pregnancy complications have yielded conflicting results. Major limitations of these studies relate to their small numbers of patients and retrospective designs. The aim of this study was to perform a systematic literature review of pregnancy outcomes in women with SLE and a meta-analysis of the association of lupus nephritis with adverse pregnancy outcomes.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched electronic databases from 1980 to 2009 and reviewed papers with validity criteria. Random-effects analytical methods were used to evaluate pregnancy complications rates.
RESULTS: Thirty-seven studies with 1842 patients and 2751 pregnancies were included. Maternal complications included lupus flare (25.6%), hypertension (16.3%), nephritis (16.1%), pre-eclampsia (7.6%), and eclampsia (0.8%). The induced abortion rate was 5.9%, and when excluded, fetal complications included spontaneous abortion (16.0%), stillbirth (3.6%), neonatal deaths (2.5%), and intrauterine growth retardation (12.7%). The unsuccessful pregnancy rate was 23.4%, and the premature birth rate was 39.4%. Meta-regression analysis showed statistically significant positive associations between premature birth rate and active nephritis and increased hypertension rates in subjects with active nephritis or a history of nephritis. History of nephritis was also associated with pre-eclampsia. Anti-phospholipid antibodies were associated with hypertension, premature birth, and an increased rate of induced abortion.
CONCLUSIONS: In patients with SLE, both lupus nephritis and anti-phospholipid antibodies increase the risks for maternal hypertension and premature births. The presented evidence further supports timing of pregnancy relative to SLE activity and multispecialty care of these patients.
Authors:
Andrew Smyth; Guilherme H M Oliveira; Brian D Lahr; Kent R Bailey; Suzanne M Norby; Vesna D Garovic
Related Documents :
20203157 - Pregnancy-associated hemolytic uremic syndrome revisited in the era of complement gene ...
15593367 - Pregnancy, cytokines, and disease activity in systemic lupus erythematosus.
16735457 - Impaired expression of endometrial differentiation markers and complement regulatory pr...
19584727 - Prevention of complete heart block in children of mothers with anti-ssa/ro and anti-ssb...
2599507 - Ultrasound-guided transfundal uterine sperm recovery from macaca fascicularis.
17885457 - Bariatric surgery and adolescent gynecology.
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Review     Date:  2010-08-05
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2011-02-18     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2060-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, National University of Ireland, Galway, Ireland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abortion, Induced
Abortion, Spontaneous / etiology
Antibodies, Antiphospholipid / blood
Female
Fetal Death / etiology
Fetal Growth Retardation / etiology
Humans
Hypertension, Pregnancy-Induced / etiology
Live Birth
Lupus Erythematosus, Systemic / blood,  complications*
Lupus Nephritis / blood,  complications*
Pregnancy
Pregnancy Complications / blood,  etiology*
Pregnancy Outcome*
Premature Birth / etiology
Risk Assessment
Risk Factors
Stillbirth
Grant Support
ID/Acronym/Agency:
K08HD051714/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Antiphospholipid
Comments/Corrections

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


Previous Document:  Discrepancy between Medical Evidence Form 2728 and renal biopsy for glomerular diseases.
Next Document:  Phylogeography of the Marine Otter (Lontra felina): historical and contemporary factors determining ...