Early-onset Preeclampsia in Lupus Pregnancy.
Early-onset Preeclampsia in Lupus Pregnancy.
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DOI：
10.1111/ppe.12332
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发表时间：
2017-01
影响因子：
2.8
通讯作者：
Salmon JE
中科院分区：
文献类型：
--
作者：
Simard JF;Arkema EV;Nguyen C;Svenungsson E;Wikström AK;Palmsten K;Salmon JE
系统性红斑狼疮（SLE）是一种慢性全身性自身免疫性疾病，发生在育龄期，与先兆子痫有关。然而，人们对早发型先兆子痫知之甚少，该病与严重的不良孕产妇和围产期结局相关。使用基于全国人口的瑞典登记册，我们确定了患有 SLE 的女性（≥2 次就诊并具有相应的 ICD 代码）和 2001-2012 年生下单胎婴儿的无 SLE 样本。根据首次、后续和所有妊娠的调整后的改良泊松模型计算 SLE 女性早发性先兆子痫（由对应于 <34 周时登记的先兆子痫的 ICD 代码定义）的风险比 (RR) 和 95% 置信区间 (CI)。在 742 名患有 SLE 的女性和 10 484 名非 SLE 女性的分娩中，分别有 32 例 (4.3%) 和 55 例 (0.5%) 被诊断为早发性先兆子痫。 SLE 与早发先兆子痫的风险增加相关（RR 7.8，95% CI 4.8，12.9，所有妊娠）。在限制没有妊娠前高血压的女性时，这种关联仍然相似。抗磷脂综合征（APS）代理的调整减弱了这种关联。与第一次和所有妊娠相比，随后妊娠的早发性先兆子痫的 RR 较小（RR 4.7，95% CI 2.0，11.2）（见上文）。患有系统性红斑狼疮的女性患早发性先兆子痫的风险增加，这种增加的风险可能与传统的危险因素孕前高血压、APS、BMI 或吸烟无关。妊娠期间患有系统性红斑狼疮的女性应密切监测早发性先兆子痫，未来的研究需要确定可能导致这种严重后果的非传统先兆子痫因素。
Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that occurs during childbearing years and has been associated with preeclampsia. However, little is known about preeclampsia of early onset, which is associated with severe adverse maternal and perinatal outcomes. Using national population-based Swedish registers we identified women with SLE (≥2 visits with corresponding ICD-codes) and a sample without SLE who gave birth to singleton infants 2001-2012. Risk ratios (RR) and 95% confidence intervals (CI) for early-onset preeclampsia (defined by ICD-codes corresponding to preeclampsia registered at <34 weeks) in SLE women were calculated based on adjusted modified Poisson models for first, subsequent, and all pregnancies. Among 742 births to women with SLE and 10 484 births to non-SLE women there were 32 (4.3%) and 55 (0.5%) diagnoses of early-onset preeclampsia, respectively. SLE was associated with an increased risk of early-onset preeclampsia (RR 7.8, 95% CI 4.8, 12.9, all pregnancies). The association remained similar upon restriction to women without pregestational hypertension. Adjustment for antiphospholipid syndrome (APS)-proxy attenuated the association. RRs for early-onset preeclampsia were smaller for subsequent pregnancies (RR 4.7, 95% CI 2.0, 11.2) compared to first and all (see above). Women with SLE are at increased risk of early-onset preeclampsia and this increased risk may be independent of the traditional risk factors pregestational hypertension, APS, BMI, or smoking. Women with SLE during pregnancy should be closely monitored for early-onset preeclampsia and future research needs to identify the non-traditional preeclampsia factors that might cause this serious outcome.
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影响因子：
4.7
作者：
Arkema, Elizabeth V.;Palmsten, Kristin;Simard, Julia F.
通讯作者：
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通讯作者：
Tincani A
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4.7
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Svenungsson, Elisabet
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4.7
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通讯作者：
Setoguchi, Soko