Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus
Introduction Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications. Materials We retrospectively r...
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| Veröffentlicht in: | Lupus 2019-04, Vol.28 (4), p.529-537 |
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| creator | Normand, G Sens, F Puthet, J Jourde-Chiche, N Lemoine, S Chauveau, D Moranne, O Rémy, P Doret, M Daugas, E Juillard, L |
| description | Introduction
Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications.
Materials
We retrospectively reviewed medical charts of pregnancies that lasted more than 22 weeks in 66 patients with pre-existing lupus nephritis between 2004 and 2013 in France. Univariate and multivariate analyses were conducted to identify determinants for maternal complications, lupus renal flare and fetal prematurity or death.
Results
Eighty-four pregnancies were identified. A maternal complication occurred in 31 pregnancies (36.9%): mostly preeclampsia (17 pregnancies, 20.2%) and renal flares (12 pregnancies, 14.3%). Overall fetal survival was 94.0% (79/84). Maternal pregnancy complications were independently associated with prepregnancy body mass index >25 kg/m2 (OR 3.81, 95% CI 1.03–14.09) and immunological activity (positive anti-dsDNA antibodies or Farr assay lupus) (OR 4.95, 95% CI 1.33–18.43). Renal lupus flares were independently associated with maternal age (OR 1.50, 95% CI 1.12–2.01) and prepregnancy immunological activity (OR 15.99, 95% CI 1.57–162.68) while a remission time >12 months had a protective effect (OR 0.17, 95% CI 0.04–0.68). Three parameters were associated with a higher risk of fetal prematurity or death: a prepregnancy body mass index >25 kg/m2 (HR 3.58, 95% CI 1.45–8.83), hypertension (HR 8.97, 95% CI 3.32–24.25), and immunological activity (HR 3.34, 95% CI 1.30–8.63).
Conclusion
Maternal age, prepregnancy hypertension, body mass index >25 kg/m2 and lupus immunological activity may be considered as the main determinants for fetal and maternal complications. A remission time above 12 months for patients with lupus nephritis could be associated with a reduced risk of renal flare during pregnancy. |
| doi_str_mv | 10.1177/0961203319832097 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_02466328v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0961203319832097</sage_id><sourcerecordid>2185874059</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-4e53fef926d1a7503e4c9eb746be0f4c3905dc0ad734a3e8ed5910057dd06743</originalsourceid><addsrcrecordid>eNp10UGL1TAQAOAgivtcvXuSgBc9VCdN2zTHZVFXeOhl7yUvmb5maZOapG_pb_HPmvLWFRY8hcx8M5kwhLxl8IkxIT6DbFgJnDPZ8hKkeEZ2rBKiyPHyOdlt6WLLX5BXMd4BQJbNS3LBQUjZCLkjv3_4RL0bV2psRBWRKp3syaaVHpZE1Rg91UPwzmo6rDOGhC5a76hyhvoThnu0xyHDgNRgwjBZp1yK1Pd0DnjMF71SvyTtJ4zUOjqrZHET9zYNNK4x4ZSbj8u8RIphTQNOKvm4xNfkRZ8HwDcP5yW5_frl9vqm2P_89v36al9oLmUqKqx5j70sG8OUqIFjpSUeRNUcEPoqI6iNBmUErxTHFk0tGUAtjIFGVPySfDy3HdTYzcFOKqydV7a7udp3WwzKqml42Z5Yth_Odg7-14IxdZONGsdROfRL7ErW1q2ooJaZvn9C7_wSXP5IVlK20HIOWcFZ6eBjDNg_TsCg23bcPd1xLnn30Hg5TGgeC_4uNYPiDKI64r9X_9vwD7URsV8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2199808330</pqid></control><display><type>article</type><title>Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus</title><source>MEDLINE</source><source>SAGE Complete</source><creator>Normand, G ; Sens, F ; Puthet, J ; Jourde-Chiche, N ; Lemoine, S ; Chauveau, D ; Moranne, O ; Rémy, P ; Doret, M ; Daugas, E ; Juillard, L</creator><creatorcontrib>Normand, G ; Sens, F ; Puthet, J ; Jourde-Chiche, N ; Lemoine, S ; Chauveau, D ; Moranne, O ; Rémy, P ; Doret, M ; Daugas, E ; Juillard, L ; French Collaborative Group on Lupus Nephritis ; on behalf of the French Collaborative Group on Lupus Nephritis</creatorcontrib><description>Introduction
Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications.
Materials
We retrospectively reviewed medical charts of pregnancies that lasted more than 22 weeks in 66 patients with pre-existing lupus nephritis between 2004 and 2013 in France. Univariate and multivariate analyses were conducted to identify determinants for maternal complications, lupus renal flare and fetal prematurity or death.
Results
Eighty-four pregnancies were identified. A maternal complication occurred in 31 pregnancies (36.9%): mostly preeclampsia (17 pregnancies, 20.2%) and renal flares (12 pregnancies, 14.3%). Overall fetal survival was 94.0% (79/84). Maternal pregnancy complications were independently associated with prepregnancy body mass index >25 kg/m2 (OR 3.81, 95% CI 1.03–14.09) and immunological activity (positive anti-dsDNA antibodies or Farr assay lupus) (OR 4.95, 95% CI 1.33–18.43). Renal lupus flares were independently associated with maternal age (OR 1.50, 95% CI 1.12–2.01) and prepregnancy immunological activity (OR 15.99, 95% CI 1.57–162.68) while a remission time >12 months had a protective effect (OR 0.17, 95% CI 0.04–0.68). Three parameters were associated with a higher risk of fetal prematurity or death: a prepregnancy body mass index >25 kg/m2 (HR 3.58, 95% CI 1.45–8.83), hypertension (HR 8.97, 95% CI 3.32–24.25), and immunological activity (HR 3.34, 95% CI 1.30–8.63).
Conclusion
Maternal age, prepregnancy hypertension, body mass index >25 kg/m2 and lupus immunological activity may be considered as the main determinants for fetal and maternal complications. A remission time above 12 months for patients with lupus nephritis could be associated with a reduced risk of renal flare during pregnancy.</description><identifier>ISSN: 0961-2033</identifier><identifier>EISSN: 1477-0962</identifier><identifier>DOI: 10.1177/0961203319832097</identifier><identifier>PMID: 30799679</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Age Factors ; Anti-DNA antibodies ; Body Mass Index ; Body weight ; Farr assay ; Female ; Fetuses ; France - epidemiology ; Health risk assessment ; Humans ; Hypertension ; Hypertension, Renal - epidemiology ; Immunology ; Infant, Newborn ; Infant, Premature ; Kaplan-Meier Estimate ; Kidneys ; Life Sciences ; Lupus ; Lupus nephritis ; Lupus Nephritis - epidemiology ; Lupus Nephritis - immunology ; Maternal Age ; Medical prognosis ; Multivariate Analysis ; Nephritis ; Overweight ; Overweight - epidemiology ; Perinatal Death - etiology ; Pre-eclampsia ; Pre-Eclampsia - epidemiology ; Preeclampsia ; Pregnancy ; Pregnancy complications ; Pregnancy Complications - epidemiology ; Pregnancy Outcome - epidemiology ; Prognosis ; Proportional Hazards Models ; Remission ; Retrospective Studies ; Risk Factors ; Stillbirth - epidemiology ; Systemic lupus erythematosus ; Young Adult</subject><ispartof>Lupus, 2019-04, Vol.28 (4), p.529-537</ispartof><rights>The Author(s) 2019</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-4e53fef926d1a7503e4c9eb746be0f4c3905dc0ad734a3e8ed5910057dd06743</citedby><cites>FETCH-LOGICAL-c399t-4e53fef926d1a7503e4c9eb746be0f4c3905dc0ad734a3e8ed5910057dd06743</cites><orcidid>0000-0003-0235-7524 ; 0000-0001-9315-1577</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0961203319832097$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0961203319832097$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,780,784,885,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30799679$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-02466328$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Normand, G</creatorcontrib><creatorcontrib>Sens, F</creatorcontrib><creatorcontrib>Puthet, J</creatorcontrib><creatorcontrib>Jourde-Chiche, N</creatorcontrib><creatorcontrib>Lemoine, S</creatorcontrib><creatorcontrib>Chauveau, D</creatorcontrib><creatorcontrib>Moranne, O</creatorcontrib><creatorcontrib>Rémy, P</creatorcontrib><creatorcontrib>Doret, M</creatorcontrib><creatorcontrib>Daugas, E</creatorcontrib><creatorcontrib>Juillard, L</creatorcontrib><creatorcontrib>French Collaborative Group on Lupus Nephritis</creatorcontrib><creatorcontrib>on behalf of the French Collaborative Group on Lupus Nephritis</creatorcontrib><title>Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus</title><title>Lupus</title><addtitle>Lupus</addtitle><description>Introduction
Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications.
Materials
We retrospectively reviewed medical charts of pregnancies that lasted more than 22 weeks in 66 patients with pre-existing lupus nephritis between 2004 and 2013 in France. Univariate and multivariate analyses were conducted to identify determinants for maternal complications, lupus renal flare and fetal prematurity or death.
Results
Eighty-four pregnancies were identified. A maternal complication occurred in 31 pregnancies (36.9%): mostly preeclampsia (17 pregnancies, 20.2%) and renal flares (12 pregnancies, 14.3%). Overall fetal survival was 94.0% (79/84). Maternal pregnancy complications were independently associated with prepregnancy body mass index >25 kg/m2 (OR 3.81, 95% CI 1.03–14.09) and immunological activity (positive anti-dsDNA antibodies or Farr assay lupus) (OR 4.95, 95% CI 1.33–18.43). Renal lupus flares were independently associated with maternal age (OR 1.50, 95% CI 1.12–2.01) and prepregnancy immunological activity (OR 15.99, 95% CI 1.57–162.68) while a remission time >12 months had a protective effect (OR 0.17, 95% CI 0.04–0.68). Three parameters were associated with a higher risk of fetal prematurity or death: a prepregnancy body mass index >25 kg/m2 (HR 3.58, 95% CI 1.45–8.83), hypertension (HR 8.97, 95% CI 3.32–24.25), and immunological activity (HR 3.34, 95% CI 1.30–8.63).
Conclusion
Maternal age, prepregnancy hypertension, body mass index >25 kg/m2 and lupus immunological activity may be considered as the main determinants for fetal and maternal complications. A remission time above 12 months for patients with lupus nephritis could be associated with a reduced risk of renal flare during pregnancy.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Anti-DNA antibodies</subject><subject>Body Mass Index</subject><subject>Body weight</subject><subject>Farr assay</subject><subject>Female</subject><subject>Fetuses</subject><subject>France - epidemiology</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Renal - epidemiology</subject><subject>Immunology</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidneys</subject><subject>Life Sciences</subject><subject>Lupus</subject><subject>Lupus nephritis</subject><subject>Lupus Nephritis - epidemiology</subject><subject>Lupus Nephritis - immunology</subject><subject>Maternal Age</subject><subject>Medical prognosis</subject><subject>Multivariate Analysis</subject><subject>Nephritis</subject><subject>Overweight</subject><subject>Overweight - epidemiology</subject><subject>Perinatal Death - etiology</subject><subject>Pre-eclampsia</subject><subject>Pre-Eclampsia - epidemiology</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Remission</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stillbirth - epidemiology</subject><subject>Systemic lupus erythematosus</subject><subject>Young Adult</subject><issn>0961-2033</issn><issn>1477-0962</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10UGL1TAQAOAgivtcvXuSgBc9VCdN2zTHZVFXeOhl7yUvmb5maZOapG_pb_HPmvLWFRY8hcx8M5kwhLxl8IkxIT6DbFgJnDPZ8hKkeEZ2rBKiyPHyOdlt6WLLX5BXMd4BQJbNS3LBQUjZCLkjv3_4RL0bV2psRBWRKp3syaaVHpZE1Rg91UPwzmo6rDOGhC5a76hyhvoThnu0xyHDgNRgwjBZp1yK1Pd0DnjMF71SvyTtJ4zUOjqrZHET9zYNNK4x4ZSbj8u8RIphTQNOKvm4xNfkRZ8HwDcP5yW5_frl9vqm2P_89v36al9oLmUqKqx5j70sG8OUqIFjpSUeRNUcEPoqI6iNBmUErxTHFk0tGUAtjIFGVPySfDy3HdTYzcFOKqydV7a7udp3WwzKqml42Z5Yth_Odg7-14IxdZONGsdROfRL7ErW1q2ooJaZvn9C7_wSXP5IVlK20HIOWcFZ6eBjDNg_TsCg23bcPd1xLnn30Hg5TGgeC_4uNYPiDKI64r9X_9vwD7URsV8</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Normand, G</creator><creator>Sens, F</creator><creator>Puthet, J</creator><creator>Jourde-Chiche, N</creator><creator>Lemoine, S</creator><creator>Chauveau, D</creator><creator>Moranne, O</creator><creator>Rémy, P</creator><creator>Doret, M</creator><creator>Daugas, E</creator><creator>Juillard, L</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0003-0235-7524</orcidid><orcidid>https://orcid.org/0000-0001-9315-1577</orcidid></search><sort><creationdate>20190401</creationdate><title>Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus</title><author>Normand, G ; Sens, F ; Puthet, J ; Jourde-Chiche, N ; Lemoine, S ; Chauveau, D ; Moranne, O ; Rémy, P ; Doret, M ; Daugas, E ; Juillard, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-4e53fef926d1a7503e4c9eb746be0f4c3905dc0ad734a3e8ed5910057dd06743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Anti-DNA antibodies</topic><topic>Body Mass Index</topic><topic>Body weight</topic><topic>Farr assay</topic><topic>Female</topic><topic>Fetuses</topic><topic>France - epidemiology</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Renal - epidemiology</topic><topic>Immunology</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidneys</topic><topic>Life Sciences</topic><topic>Lupus</topic><topic>Lupus nephritis</topic><topic>Lupus Nephritis - epidemiology</topic><topic>Lupus Nephritis - immunology</topic><topic>Maternal Age</topic><topic>Medical prognosis</topic><topic>Multivariate Analysis</topic><topic>Nephritis</topic><topic>Overweight</topic><topic>Overweight - epidemiology</topic><topic>Perinatal Death - etiology</topic><topic>Pre-eclampsia</topic><topic>Pre-Eclampsia - epidemiology</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy complications</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Remission</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stillbirth - epidemiology</topic><topic>Systemic lupus erythematosus</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Normand, G</creatorcontrib><creatorcontrib>Sens, F</creatorcontrib><creatorcontrib>Puthet, J</creatorcontrib><creatorcontrib>Jourde-Chiche, N</creatorcontrib><creatorcontrib>Lemoine, S</creatorcontrib><creatorcontrib>Chauveau, D</creatorcontrib><creatorcontrib>Moranne, O</creatorcontrib><creatorcontrib>Rémy, P</creatorcontrib><creatorcontrib>Doret, M</creatorcontrib><creatorcontrib>Daugas, E</creatorcontrib><creatorcontrib>Juillard, L</creatorcontrib><creatorcontrib>French Collaborative Group on Lupus Nephritis</creatorcontrib><creatorcontrib>on behalf of the French Collaborative Group on Lupus Nephritis</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Lupus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Normand, G</au><au>Sens, F</au><au>Puthet, J</au><au>Jourde-Chiche, N</au><au>Lemoine, S</au><au>Chauveau, D</au><au>Moranne, O</au><au>Rémy, P</au><au>Doret, M</au><au>Daugas, E</au><au>Juillard, L</au><aucorp>French Collaborative Group on Lupus Nephritis</aucorp><aucorp>on behalf of the French Collaborative Group on Lupus Nephritis</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus</atitle><jtitle>Lupus</jtitle><addtitle>Lupus</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>28</volume><issue>4</issue><spage>529</spage><epage>537</epage><pages>529-537</pages><issn>0961-2033</issn><eissn>1477-0962</eissn><abstract>Introduction
Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications.
Materials
We retrospectively reviewed medical charts of pregnancies that lasted more than 22 weeks in 66 patients with pre-existing lupus nephritis between 2004 and 2013 in France. Univariate and multivariate analyses were conducted to identify determinants for maternal complications, lupus renal flare and fetal prematurity or death.
Results
Eighty-four pregnancies were identified. A maternal complication occurred in 31 pregnancies (36.9%): mostly preeclampsia (17 pregnancies, 20.2%) and renal flares (12 pregnancies, 14.3%). Overall fetal survival was 94.0% (79/84). Maternal pregnancy complications were independently associated with prepregnancy body mass index >25 kg/m2 (OR 3.81, 95% CI 1.03–14.09) and immunological activity (positive anti-dsDNA antibodies or Farr assay lupus) (OR 4.95, 95% CI 1.33–18.43). Renal lupus flares were independently associated with maternal age (OR 1.50, 95% CI 1.12–2.01) and prepregnancy immunological activity (OR 15.99, 95% CI 1.57–162.68) while a remission time >12 months had a protective effect (OR 0.17, 95% CI 0.04–0.68). Three parameters were associated with a higher risk of fetal prematurity or death: a prepregnancy body mass index >25 kg/m2 (HR 3.58, 95% CI 1.45–8.83), hypertension (HR 8.97, 95% CI 3.32–24.25), and immunological activity (HR 3.34, 95% CI 1.30–8.63).
Conclusion
Maternal age, prepregnancy hypertension, body mass index >25 kg/m2 and lupus immunological activity may be considered as the main determinants for fetal and maternal complications. A remission time above 12 months for patients with lupus nephritis could be associated with a reduced risk of renal flare during pregnancy.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>30799679</pmid><doi>10.1177/0961203319832097</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0235-7524</orcidid><orcidid>https://orcid.org/0000-0001-9315-1577</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Lupus, 2019-04, Vol.28 (4), p.529-537 |
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| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_02466328v1 |
| source | MEDLINE; SAGE Complete |
| subjects | Adult Age Factors Anti-DNA antibodies Body Mass Index Body weight Farr assay Female Fetuses France - epidemiology Health risk assessment Humans Hypertension Hypertension, Renal - epidemiology Immunology Infant, Newborn Infant, Premature Kaplan-Meier Estimate Kidneys Life Sciences Lupus Lupus nephritis Lupus Nephritis - epidemiology Lupus Nephritis - immunology Maternal Age Medical prognosis Multivariate Analysis Nephritis Overweight Overweight - epidemiology Perinatal Death - etiology Pre-eclampsia Pre-Eclampsia - epidemiology Preeclampsia Pregnancy Pregnancy complications Pregnancy Complications - epidemiology Pregnancy Outcome - epidemiology Prognosis Proportional Hazards Models Remission Retrospective Studies Risk Factors Stillbirth - epidemiology Systemic lupus erythematosus Young Adult |
| title | Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus |
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