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. 2022 Aug-Sep;18(7):416-421.
doi: 10.1016/j.reumae.2021.02.008. Epub 2021 Sep 17.

Is lupus nephritis a prognosis factor for pregnancy? Maternal and foetal outcomes

Cintia Otaduy  1 , Carla Andrea Gobbi  2 , Alejandro Álvarez  3 , Eduardo Horacio Albiero  4 , Marcelo Augusto Yorio  5 , Paula Alba Moreyra  6
Affiliations
Free article

Is lupus nephritis a prognosis factor for pregnancy? Maternal and foetal outcomes

Cintia Otaduy et al. Reumatol Clin (Engl Ed). 2022 Aug-Sep.
Free article

Abstract

Background: Pregnancy in women with systemic lupus erythematosus (SLE) and nephritis (LN) is at risk of foetal and maternal complications.

Objective: To evaluate the effect of LN on pregnancy with respect to foetal and maternal outcome.

Methods: We retrospectively studied all pregnant SLE patients with and without diagnosis of LN, who attended the Materno Neonatal Hospital in Cordoba city, Argentina, from January 2015 to April 2017. Demographic, clinical, and laboratory data were collected. The presence of antiphospholipid syndrome (APS) and antiphospholipid antibodies (AAF), and maternal and foetal outcome were evaluated.

Results: 121 pregnancies in 79 patients were included. Pregnancies were divided into those with LN (69) and those without LN (52). The presence of APS and AAF was more frequent in the LN group as well as higher basal SLEDAI. The LN group received more immunosuppressive therapy and increased steroid dose treatment. Of the patients, 47.5% had Class IV LN. Lupus flares occurred more frequently in the LN group 25.8% vs 10.9% in the group without LN (P = .041), mainly renal flares in the LN group. No patients developed end-stage renal failure. Preeclampsia was more frequent in the LN group, 18.8% vs 6.3% in the group without LN (P = .047). There was only one maternal death. A caesarean section was required in 68.5% of the LN group vs 31.5 in the group without LN, and urgent caesarean section was also performed in the LN group. There were no differences in foetal outcomes in either group: live birth, gestational age, weight birth, perinatal death, foetal distress.

Conclusions: Patients with LN experienced more maternal complications such as lupus flares and preeclampsia. However, LN does not lead to a worse pregnancy and foetal outcome. Patients should be strictly monitored before and after conception.

Keywords: Embarazo; Foetal outcome; Lupus eritematoso sistémico; Lupus nephritis; Nefritis lúpica; Pregnancy; Pronostico materno fetal; Systemic lupus erythematosus.

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