Pregnancy outcomes before and after a diagnosis of systemic lupus erythematosus
Pregnancy outcomes before and after a diagnosis of systemic lupus erythematosus
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DOI：
10.1016/j.ajog.2005.02.104
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发表时间：
2005-10-01
影响因子：
9.8
通讯作者：
Sokol, RJ
中科院分区：
文献类型：
--
作者：
Dhar, JP;Essenmacher, LM;Sokol, RJ
目的：本研究的目的是评估妊娠。狼疮前后的结果研究设计：连续选择标准应用于148例狼疮和78，905例非狼疮妊娠，分为3组：狼疮组，84例妊娠（未诊断组，15例女性;已诊断组，69例女性），对照组，51，000例妊娠。结果：狼疮组死胎率高于对照组，统计学处理采用三因素方差分析和卡方检验比值比为4.84 [95% CI为1.72，11.08];未确诊组（优势比，9.89 [95%CI，1.09，42.63]）和已确诊组（优势比，3.85 [95%CI，1.02，10.31]）。考虑到每例患者> 1次妊娠会高估死胎率。以中枢神经系统受累为标志的严重母体疾病会显著增加死产风险。已确诊组有更多的高血压并发症（P =.001和.0001）。狼疮组均显示早产3胎（P = 0.03），生长受限（P = 0.019）和极低出生体重婴儿（P = 0.021）的比例显著高于对照组（control group.Conclusion）：妊娠合并狼疮的胎儿结局不佳，即使在疾病临床表现之前，也支持疾病前状态。(C)2005 Mosby，Inc. All rights reserved.
Objective: The purpose of this study was to evaluate pregnancy. outcomes before and after of lupus. design:Study Successive selection criterion applied to 148 lupus and 78,905 non-lupus pregnancies, generated 3 groups: lupus group, 84 pregnancies (not-yet-diagnosed group, 15 women; already-diagnosed group, 69 women), and control group, 51,000 pregnancies. Three-way analysis of variance and the chi-squared test were used for analyses.Results: Stillbirth outcome was increased in the lupus group compared with the control group (odds ratio, 4.84 [95% CI, 1.72,11.08]); the not-yet-diagnosed group (odds ratio, 9.89 [95% Cl, 1.09,42.63]), and the already-diagnosed group (odds ratio, 3.85 [95% Cl, 1.02,10.31]). Considering > 1 pregnancy per patient would have overestimated the stillbirth rate. Stillbirth risk was increased significantly in severe maternal disease that was marked by central nervous system involvement. The already-diagnosed group had more hypertensive complications (P =.001 and.0001). Both lupus groups showed a significantly greater proportion of preterm 3 births (P =.03), growth restriction (P =.019), and infants in the very low birth weight category (P =.021) compared with the control group.Conclusion: Poor fetal outcomes are seen in pregnancies that are complicated by lupus, even before clinical appearance of disease, which supports a predisease state. (C) 2005 Mosby, Inc. All rights reserved.