Pregnancy outcomes among Chinese women with and without systemic lupus erythematosus: a retrospective cohort study.
Pregnancy outcomes among Chinese women with and without systemic lupus erythematosus: a retrospective cohort study.
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DOI：
10.1136/bmjopen-2017-020909
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发表时间：
2018-04-13
期刊：
影响因子：
2.9
通讯作者：
Zhang WH
中科院分区：
文献类型：
--
作者：
Wu J;Ma J;Bao C;Di W;Zhang WH
全面和定量地确定系统性红斑狼疮（SLE）对中国队列妊娠结局的影响。回顾性队列研究。数据于2011年9月至2017年5月在中国上海的一家三级医疗中心收集。我们将338名SLE孕妇纳入研究队列，随机选择1014名非SLE孕妇（每名SLE妇女3名）纳入比较队列。回顾性分析所有孕妇的相关医疗记录。多胎妊娠和因个人原因进行人工流产的病例被排除在外。母胎结局是主要结局，产前护理管理是次要结局。妊娠高血压（OR 2.68, 95% CI 1.75 ~ 4.09）、先兆子痫（OR 3.13, 95% CI 1.95 ~ 5.03）和胎膜早破（OR 2.53, 95% CI 1.46 ~ 4.40）的风险在SLE患者和非SLE患者之间存在显著差异。妊娠期糖尿病与孕妇SLE呈负相关（OR 0.49, 95% CI 0.28 ~ 0.85）。孕妇与系统性红斑狼疮显示胎儿损失发生率显著增加(或10.23,95%可信区间5.08到20.59),包括自然流产(或4.42,95%可信区间1.52到12.80),治疗性流产(或16.57,95%可信区间5.80到47.35)和死产(或13.25,95%可信区间1.49到118.11),和一个早产的风险更高(或3.15,95%可信区间2.21到4.50),宫内生长受限(或2.20,95%可信区间1.35到3.58),一个很小的孩子在胎龄(或1.86,95%可信区间1.11到3.13),在调整混杂因素后，剖腹产（OR 4.73, 95% CI 3.30至6.80）或新生儿重症监护病房入院（OR 3.48, 95% CI 2.21至5.48）的发生率高于非sle人群中的女性。在本研究中，SLE显著增加了不良妊娠结局的风险。因此，风湿病学家和产科医生应该对SLE孕妇进行孕前评估和密切的产前监测。
To completely and quantifiably determine the effect of systemic lupus erythematosus (SLE) on pregnancy outcomes in a Chinese cohort. A retrospective cohort study. Data were collected at a tertiary medical centre located in Shanghai, China, from September 2011 to May 2017. We assigned 338 pregnant women with SLE to the study cohort and 1014 randomly selected pregnant women without SLE (three for every woman with SLE) to a comparison cohort. The relevant medical records of all pregnant women were retrospectively reviewed. Cases of multiple pregnancy and cases in which an artificial abortion was performed for personal reasons were excluded. Maternal and fetal outcomes were primary outcomes, and management of antenatal care was the secondary outcome. The risks of pregnancy-induced hypertension (OR 2.68, 95% CI 1.75 to 4.09), pre-eclampsia (OR 3.13, 95% CI 1.95 to 5.03) and premature rupture of membranes (OR 2.53, 95% CI 1.46 to 4.40) were significantly different between women with and without SLE. Gestational diabetes was negatively associated with SLE in pregnant women (OR 0.49, 95% CI 0.28 to 0.85). Pregnant women with SLE displayed significantly higher rates of fetal loss (OR 10.23, 95% CI 5.08 to 20.59), including spontaneous abortion (OR 4.42, 95% CI 1.52 to 12.80), therapeutic abortion (OR 16.57, 95% CI 5.80 to 47.35) and stillbirth (OR 13.25, 95% CI 1.49 to 118.11), and a higher risk of preterm birth (OR 3.15, 95% CI 2.21 to 4.50), intrauterine growth restriction (OR 2.20, 95% CI 1.35 to 3.58), a child who was small for the gestational age (OR 1.86, 95% CI 1.11 to 3.13), a caesarean section (OR 4.73, 95% CI 3.30 to 6.80) or a neonatal intensive care unit admission (OR 3.48, 95% CI 2.21 to 5.48) than women in the non-SLE population after adjusting for confounding factors. In this study, SLE significantly increased the risk of adverse pregnancy outcomes. Therefore, a preconception assessment and close antenatal monitoring by both rheumatologists and obstetricians should be performed in pregnant women with SLE.
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影响因子：
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作者：
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