scholarly journals Fetal and Maternal Outcomes of Planned Pregnancy in Patients with Systemic Lupus Erythematosus: A Retrospective Multicenter Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Dongying Chen ◽  
Minxi Lao ◽  
Jianyu Zhang ◽  
Yanfeng Zhan ◽  
Weinian Li ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Multicenter Study ◽  
Lupus Erythematosus ◽  
Gestational Hypertension ◽  
Severe Disease ◽  
Fetal Loss ◽  
Anticardiolipin Antibody ◽  
Maternal Outcomes ◽  
Planned Pregnancy ◽  
Retrospective Multicenter Study

Objective. To investigate the fetal and maternal outcomes as well as predictors of APOs in women with SLE who conceived when the disease was stable, the so-called “planned pregnancy.” Methods. A retrospective multicenter study of 243 patients with SLE who underwent a planned pregnancy was performed. APOs in fetus and mothers were recorded. Results. The average age at conception was 28.9 ± 3.9 years. Duration of SLE prior to pregnancy was 4.4 ± 4.3 years. Fetal APOs occurred in 86 (86/243, 35.4%) patients. Preterm births, intrauterine growth retardation (IUGR), fetal distress, and fetal loss accounted for 22.2%, 14.8%, 11.1%, and 4.9%, respectively. Forty-two preterm infants (42/54, 77.8%) were delivered after the 34th week of gestation. All the preterm infants were viable. Fifty-two patients (52/243, 21.4%) had disease flares, among which 45 cases (45/52, 86.5%) were mild, 6 (6/52, 11.5%) were moderate, and 1 (1/52, 1.9%) was severe. Disease flares were mainly presented as active lupus nephritis (41/52, 78.8%), thrombocytopenia (10/52, 19.2%), and skin/mucosa lesions (9/52, 17.3%). Pregnancy-induced hypertension (PIH) occurred in 29 patients, among which 3 were gestational hypertension and 26 were preeclampsia. Multiple analysis showed that disease flares (OR, 8.1; CI, 3.8–17.2) and anticardiolipin antibody positivity (OR, 7.4; CI, 2.5–21.8) were associated with composite fetal APOs. Conclusion. Planned pregnancy improved fetal and maternal outcomes, presenting as a lower rate of fetal loss, more favorable outcomes for preterm infants, and less severe disease flares during pregnancy.

Pregnancy and antiphospholipid antibody

2001 ◽  
Vol 21 (02) ◽  
pp. 66-76 ◽  
Author(s):  
L. R. Sammaritano ◽  
M. D. Lockshin
Keyword(s):  
Lupus Erythematosus ◽  
Pregnancy Loss ◽  
Post Partum ◽  
Survival Rates ◽  
Fetal Loss ◽  
Anticardiolipin Antibody ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Fetal Survival ◽  
Normal Women

SummaryThe antiphospholipid antibody syndrome is defined by anticardiolipin antibody or lupus anticoagulant and recurrent pregnancy loss or recurrent thrombosis. Approximately one-third of patients with systemic lupus erythematosus, 10-15% of women with recurrent fetal loss, and 1-2% of normal women have one or both of these antibodies. The true antigen is a phospholipid-binding protein, β2-glycoprotein I, not cardiolipin. Risk for pregnancy loss is determined by IgG isotype titer, and prior pregnancy history. Early pregnancy is often normal, but placental insufficiency produces slowed fetal growth and second trimester fetal demise. The most likely mechanism is unimpeded thrombosis within the placental circulation, possibly because antiphospholipid antibody competes with placental anticoagulant I. Heparin in subanticoagulant doses plus low dose aspirin results in fetal survival rates of over 90%. Post partum, the long-term risk of maternal arterial or venous thrombosis is high.

scholarly journals P171 Immune-mediated diseases (IMID) and COVID-19: results from an observational retrospective multicenter study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S246-S246
Author(s):  
C Calviño Suárez ◽  
R Dos-Santos ◽  
I Baston-Rey ◽  
F J Montero ◽  
R Ferreiro-Iglesias ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Severe Disease ◽  
Multivariable Analysis ◽  
Female Gender ◽  
Univariable Analysis ◽  
Santiago De Compostela ◽  
Immune Mediated ◽  
Hospital Patients ◽  
Novel Coronavirus ◽  
Retrospective Multicenter Study

Abstract Background The novel coronavirus emerged in 2019 in Wuhan has caused a global pandemic of coronavirus disease (COVID-19). Immune-mediated diseases (IMID), as inflammatory arthritis or inflammatory bowel disease (IBD), have some special implications due to their pathogenesis and treatments. Some treatments employed in IMID are now being used in the treatment of severe COVID-19. There still exists controversy about IMID behavior and its complications. Our aim was to assess COVID-19 severity in IMID patients and its prognosis predictors. Methods An observational retrospective multicenter study was performed in two Spanish Hospitals (University Clinical Hospital in Santiago de Compostela and Gregorio Marañón Hospital). Patients were selected if they were diagnosed of an IMID (rheumatoid arthritis, psoriatic arthritis, espondyloarthritis, ulcerative colitis and Crohn’s disease) and had COVID-19 infection between February and April 2020. Demographic, clinical, analytical and treatment data were collected. Stata 15.1 was used to perform statistical analysis. Results 91 patients were included. 55 suffered from a rheumatic disease and 36 suffered IBD. Univariable analysis reached age, comorbidity, female gender, flu vaccine, arthropathy, basal csDMARD, pneumonia and basal CRP as potential predictors of non-severe (absence of death, respiratory insufficiency, intensive care unit admission or sepsis) COVID-19 disease (p < 0.2). After multivariable analysis, only female gender (OR 4.60 [CI95% 1.00, 21.2] p=0.050), lower age (OR 0.94 [CI95% 0.88, 1.00] p=0.042) and lower basal levels of CRP (OR 0.87 [CI95% 0.77, 0.97] p=0.010) were predictors for non-severe disease (p < 0.005). Mean time of healing (symptoms solved in outpatient and hospital discharge in admitted) from COVID-19 was 13.8 days (SD 16.3). Univariable analysis showed arthropathy, COVID-19 symptomatic and basal GC dose as potential predictors of higher time-to-healing from COVID-19 disease (p < 0.2). After multivariable analysis, only lower GC basal dose predicts higher time-to-healing (OR -1.83 [CI95% -2.81, -0.84] p=0.001).11 patients deceased because of SARS-CoV-2 infection. Univariable analysis reached age, basal csDMARD, pneumonia and basal CRP as potential predictors of COVID-19 mortality (p < 0.2). After multivariable analysis, only higher age was a predictor for mortality (OR 1.14 [CI95% 1.04,1.25] p=0.006). Conclusion IMID patients showed similar predictors of mortality than general population involving COVID-19. Immune-modulating agents did not seem to overshadow the prognosis of COVID-19 infection. Female gender, lower age and lower basal CRP is associated with mild COVID-19 disease as well higher age points out the worst prognosis. Even that, each case should be individualized.

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