Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy
Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and...
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| Veröffentlicht in: | Clinical rheumatology 2012-05, Vol.31 (5), p.813-819 |
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| creator | Saavedra, Miguel A. Cruz-Reyes, Claudia Vera-Lastra, Olga Romero, Griselda T. Cruz-Cruz, Polita Arias-Flores, Rafael Jara, Luis J. |
| description | Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and without previous lupus nephritis. We analyzed the clinical records of pregnant SLE patients attended in a tertiary reference center during a 5-year period. Patients were allocated into two groups according to the presence or absence of previous lupus nephritis. Women were evaluated monthly during pregnancy and at least 1 month postpartum. Maternal and fetal outcomes of pregnancy were abstracted. We included 95 pregnancies in 92 patients. Compared with pregnant women without lupus nephritis (
n
= 60), pregnancies with previous lupus nephritis (
n
= 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%,
p
= 0.00001), higher rate of lupus flares (54.2% vs. 25%,
p
= 0.004), and renal flares (45.7% vs. 6.6%,
p
= 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups. |
| doi_str_mv | 10.1007/s10067-012-1941-4 |
| format | Article |
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n
= 60), pregnancies with previous lupus nephritis (
n
= 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%,
p
= 0.00001), higher rate of lupus flares (54.2% vs. 25%,
p
= 0.004), and renal flares (45.7% vs. 6.6%,
p
= 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups.</description><identifier>ISSN: 0770-3198</identifier><identifier>EISSN: 1434-9949</identifier><identifier>DOI: 10.1007/s10067-012-1941-4</identifier><identifier>PMID: 22278163</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Adult ; Antimalarials - therapeutic use ; Azathioprine - therapeutic use ; Comorbidity ; Drug Therapy, Combination ; Female ; Fetal Diseases - diagnosis ; Fetal Diseases - epidemiology ; Humans ; Immunosuppressive Agents - therapeutic use ; Lupus Nephritis - drug therapy ; Lupus Nephritis - epidemiology ; Medicine ; Medicine & Public Health ; Mexico - epidemiology ; Multivariate Analysis ; Original Article ; Prednisone - therapeutic use ; Pregnancy ; Pregnancy Complications - epidemiology ; Pregnancy Outcome ; Prognosis ; Rheumatology</subject><ispartof>Clinical rheumatology, 2012-05, Vol.31 (5), p.813-819</ispartof><rights>Clinical Rheumatology 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-1e4b4cb841f2308600e48c4c09e127cb8ec7145d0adf7fb486df0bd5ac112df63</citedby><cites>FETCH-LOGICAL-c438t-1e4b4cb841f2308600e48c4c09e127cb8ec7145d0adf7fb486df0bd5ac112df63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10067-012-1941-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10067-012-1941-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22278163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saavedra, Miguel A.</creatorcontrib><creatorcontrib>Cruz-Reyes, Claudia</creatorcontrib><creatorcontrib>Vera-Lastra, Olga</creatorcontrib><creatorcontrib>Romero, Griselda T.</creatorcontrib><creatorcontrib>Cruz-Cruz, Polita</creatorcontrib><creatorcontrib>Arias-Flores, Rafael</creatorcontrib><creatorcontrib>Jara, Luis J.</creatorcontrib><title>Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy</title><title>Clinical rheumatology</title><addtitle>Clin Rheumatol</addtitle><addtitle>Clin Rheumatol</addtitle><description>Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and without previous lupus nephritis. We analyzed the clinical records of pregnant SLE patients attended in a tertiary reference center during a 5-year period. Patients were allocated into two groups according to the presence or absence of previous lupus nephritis. Women were evaluated monthly during pregnancy and at least 1 month postpartum. Maternal and fetal outcomes of pregnancy were abstracted. We included 95 pregnancies in 92 patients. Compared with pregnant women without lupus nephritis (
n
= 60), pregnancies with previous lupus nephritis (
n
= 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%,
p
= 0.00001), higher rate of lupus flares (54.2% vs. 25%,
p
= 0.004), and renal flares (45.7% vs. 6.6%,
p
= 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups.</description><subject>Adult</subject><subject>Antimalarials - therapeutic use</subject><subject>Azathioprine - therapeutic use</subject><subject>Comorbidity</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Fetal Diseases - diagnosis</subject><subject>Fetal Diseases - epidemiology</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Lupus Nephritis - drug therapy</subject><subject>Lupus Nephritis - epidemiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mexico - epidemiology</subject><subject>Multivariate Analysis</subject><subject>Original Article</subject><subject>Prednisone - therapeutic use</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy Outcome</subject><subject>Prognosis</subject><subject>Rheumatology</subject><issn>0770-3198</issn><issn>1434-9949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kF1LwzAUhoMobk5_gDdS8Lp6TnrWtJcy_BgIguh1SdNkdqxNTVph_96UTvHGm5NAnvdN8jB2iXCDAOLWh5mKGJDHmBPGdMTmSAnFeU75MZuDEBAnmGczdub9FgB4luMpm3HORYZpMmev66aTqo-siTqnv2o7-Gg3dGG2uvtwdV_7yLZRI3vtWrmLZFtFRvdhZ4de2Ub7qBpc3W7G-KaVrdqfsxMjd15fHNYFe3-4f1s9xc8vj-vV3XOsKMn6GDWVpMqM0PAEshRAU6ZIQa6Ri3CglUBaViArI0xJWVoZKKulVIi8MmmyYNdTb-fs56B9X2ztMD7SFwiYEJFIIVA4UcpZ7502RefqRrp9gIrRYjFZLILFYrRYUMhcHZqHstHVb-JHWwD4BPhu_Lt2f6_-r_UbJ5R9kg</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Saavedra, Miguel A.</creator><creator>Cruz-Reyes, Claudia</creator><creator>Vera-Lastra, Olga</creator><creator>Romero, Griselda T.</creator><creator>Cruz-Cruz, Polita</creator><creator>Arias-Flores, Rafael</creator><creator>Jara, Luis J.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</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>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20120501</creationdate><title>Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy</title><author>Saavedra, Miguel A. ; Cruz-Reyes, Claudia ; Vera-Lastra, Olga ; Romero, Griselda T. ; Cruz-Cruz, Polita ; Arias-Flores, Rafael ; Jara, Luis J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-1e4b4cb841f2308600e48c4c09e127cb8ec7145d0adf7fb486df0bd5ac112df63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Antimalarials - therapeutic use</topic><topic>Azathioprine - therapeutic use</topic><topic>Comorbidity</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Fetal Diseases - diagnosis</topic><topic>Fetal Diseases - epidemiology</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Lupus Nephritis - drug therapy</topic><topic>Lupus Nephritis - epidemiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mexico - epidemiology</topic><topic>Multivariate Analysis</topic><topic>Original Article</topic><topic>Prednisone - therapeutic use</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy Outcome</topic><topic>Prognosis</topic><topic>Rheumatology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saavedra, Miguel A.</creatorcontrib><creatorcontrib>Cruz-Reyes, Claudia</creatorcontrib><creatorcontrib>Vera-Lastra, Olga</creatorcontrib><creatorcontrib>Romero, Griselda T.</creatorcontrib><creatorcontrib>Cruz-Cruz, Polita</creatorcontrib><creatorcontrib>Arias-Flores, Rafael</creatorcontrib><creatorcontrib>Jara, Luis J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Clinical rheumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saavedra, Miguel A.</au><au>Cruz-Reyes, Claudia</au><au>Vera-Lastra, Olga</au><au>Romero, Griselda T.</au><au>Cruz-Cruz, Polita</au><au>Arias-Flores, Rafael</au><au>Jara, Luis J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy</atitle><jtitle>Clinical rheumatology</jtitle><stitle>Clin Rheumatol</stitle><addtitle>Clin Rheumatol</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>31</volume><issue>5</issue><spage>813</spage><epage>819</epage><pages>813-819</pages><issn>0770-3198</issn><eissn>1434-9949</eissn><abstract>Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and without previous lupus nephritis. We analyzed the clinical records of pregnant SLE patients attended in a tertiary reference center during a 5-year period. Patients were allocated into two groups according to the presence or absence of previous lupus nephritis. Women were evaluated monthly during pregnancy and at least 1 month postpartum. Maternal and fetal outcomes of pregnancy were abstracted. We included 95 pregnancies in 92 patients. Compared with pregnant women without lupus nephritis (
n
= 60), pregnancies with previous lupus nephritis (
n
= 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%,
p
= 0.00001), higher rate of lupus flares (54.2% vs. 25%,
p
= 0.004), and renal flares (45.7% vs. 6.6%,
p
= 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>22278163</pmid><doi>10.1007/s10067-012-1941-4</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0770-3198 |
| ispartof | Clinical rheumatology, 2012-05, Vol.31 (5), p.813-819 |
| issn | 0770-3198 1434-9949 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Antimalarials - therapeutic use Azathioprine - therapeutic use Comorbidity Drug Therapy, Combination Female Fetal Diseases - diagnosis Fetal Diseases - epidemiology Humans Immunosuppressive Agents - therapeutic use Lupus Nephritis - drug therapy Lupus Nephritis - epidemiology Medicine Medicine & Public Health Mexico - epidemiology Multivariate Analysis Original Article Prednisone - therapeutic use Pregnancy Pregnancy Complications - epidemiology Pregnancy Outcome Prognosis Rheumatology |
| title | Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy |
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