Evaluation of lupus anticoagulant, damage, and remission as predictors of pregnancy complications in systemic lupus erythematosus: the French GR2 study.
Evaluation of lupus anticoagulant, damage, and remission as predictors of pregnancy complications in systemic lupus erythematosus: the French GR2 study.
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DOI：
10.1093/rheumatology/keab943
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发表时间：
2022-08-30
期刊：
影响因子：
5.5
通讯作者：
Costedoat-Chalumeau, Nathalie
中科院分区：
文献类型：
--
作者：
Larosa, Maddalena;Le Guern, Veronique;Guettrot-Imbert, Gaelle;Morel, Nathalie;Abisror, Noemie;Morati-Hafsaoui, Chafika;Orquevaux, Pauline;Diot, Elisabeth;Doria, Andrea;Reynauld, Francoise Sarrot;Limal, Nicolas;Queyrel, Viviane;Souchaud-Debouverie, Odile;Sailler, Laurent;Le Besnerais, Maelle;Goulenok, Tiphaine;Molto, Anna;Pannier-Metzger, Emmanuelle;Sentilhes, Loic;Mouthon, Luc;Lazaro, Estibaliz;Costedoat-Chalumeau, Nathalie
缓解状态、狼疮低疾病活动状态（LLDAS）和损害累积对SLE妇女妊娠预后的具体作用尚不清楚。我们分析了它们对母体耀斑和不良妊娠结局（APOs）的影响。我们评估了所有参加前瞻性GR2研究的SLE女性（≥18岁），这些女性在12周时仍有单胎妊娠（1例妊娠/例）。几套标准被用来定义缓解、疾病活动性和损害。apo包括：胎儿/新生儿死亡、胎盘功能不全伴早产和小于胎龄出生体重。孕早期母体和疾病特征作为母体耀斑和apo的预测因子进行了测试。该研究包括238名妇女（98.3%服用羟氯喹（HCQ））和230名活产婴儿。35例（14.7%）患者在妊娠中晚期至少有一次发作。34例（14.3%）女性发生至少1例apo。妊娠早期补体不足是妊娠后期与母体耀斑相关的唯一因素（P=0.02），而其他因素与apo相关。在logistic回归模型中，slicc -损伤指数造成的损伤[模型1的比值比（OR）为1.8,95% CI: 1.1, 2.9，模型2的比值比为1.7,95% CI: 1.1, 2.8]和狼疮抗凝剂（模型1的比值比为4.2,95% CI: 1.8, 9.7；模型2的比值比为3.7,95% CI: 1.6, 8.7）与APOs显著相关。LA和妊娠损伤是apo的预测因子，妊娠早期补体不足与妊娠后期的母体发作相关，该队列的孕妇大多患有HCQ治疗的控制良好的SLE。ClinicalTrials.gov, https://clinicaltrials.gov, NCT02450396。
The specific roles of remission status, lupus low disease activity state (LLDAS), and damage accrual on the prognosis of pregnancies in women with SLE are unknown. We analysed their impact on maternal flares and adverse pregnancy outcomes (APOs). We evaluated all women (≥18 years) with SLE enrolled in the prospective GR2 study with an ongoing singleton pregnancy at 12 weeks (one pregnancy/woman). Several sets of criteria were used to define remission, disease activity and damage. APOs included: foetal/neonatal death, placental insufficiency with preterm delivery and small-for-gestational-age birth weight. First trimester maternal and disease features were tested as predictors of maternal flares and APOs. The study included 238 women (98.3% on hydroxychloroquine (HCQ)) with 230 live births. Thirty-five (14.7%) patients had at least one flare during the second/third trimester. At least one APOs occurred in 34 (14.3%) women. Hypocomplementemia in the first trimester was the only factor associated with maternal flares later in pregnancy (P=0.02), while several factors were associated with APOs. In the logistic regression models, damage by SLICC-Damage Index [odds ratio (OR) 1.8, 95% CI: 1.1, 2.9 for model 1 and OR 1.7, 95% CI: 1.1, 2.8 for model 2] and lupus anticoagulant (LA, OR 4.2, 95% CI: 1.8, 9.7 for model 1; OR 3.7, 95% CI: 1.6, 8.7 for model 2) were significantly associated with APOs. LA and damage at conception were predictors of APOs, and hypocomplementemia in the first trimester was associated with maternal flares later in pregnancy in this cohort of pregnant patients mostly with well-controlled SLE treated with HCQ. ClinicalTrials.gov, https://clinicaltrials.gov, NCT02450396.
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影响因子：
27.4
作者：
van Vollenhoven, Ronald;Voskuyl, Alexandre;Ward, Michael
通讯作者：
Ward, Michael
影响因子：
--
作者：
Petri, Michelle;Orbai, Ana-Maria;Alarcon, Graciela S.;Gordon, Caroline;Merrill, Joan T.;Fortin, Paul R.;Bruce, Ian N.;Isenberg, David;Wallace, Daniel J.;Nived, Ola;Sturfelt, Gunnar;Ramsey-Goldman, Rosalind;Bae, Sang-Cheol;Hanly, John G.;Sanchez-Guerrero, Jorge;Clarke, Ann;Aranow, Cynthia;Manzi, Susan;Urowitz, Murray;Gladman, Dafna;Kalunian, Kenneth;Costner, Melissa;Werth, Victoria P.;Zoma, Asad;Bernatsky, Sasha;Ruiz-Irastorza, Guillermo;Khamashta, Munther A.;Jacobsen, Soren;Buyon, Jill P.;Maddison, Peter;Dooley, Mary Anne;van vollenhoven, Ronald F.;Ginzler, Ellen;Stoll, Thomas;Peschken, Christine;Jorizzo, Joseph L.;Callen, Jeffrey P.;Lim, S. Sam;Fessler, Barri J.;Inanc, Murat;Kamen, Diane L.;Rahman, Anisur;Steinsson, Kristjan;Franks, Andrew G., Jr.;Sigler, Lisa;Hameed, Suhail;Fang, Hong;Ngoc Pham;Brey, Robin;Weisman, Michael H.;McGwin, Gerald, Jr.;Magder, Laurence S.
通讯作者：
Magder, Laurence S.
DOI：
10.1002/art.40571
发表时间：
2018-11
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
Petri M;Magder LS
通讯作者：
Magder LS
影响因子：
4.9
作者：
Meissner, Yvette;Strangfeld, Anja;Fischer-Betz, Rebecca
通讯作者：
Fischer-Betz, Rebecca
影响因子：
27.4
作者：
Bruce IN;O'Keeffe AG;Farewell V;Hanly JG;Manzi S;Su L;Gladman DD;Bae SC;Sanchez-Guerrero J;Romero-Diaz J;Gordon C;Wallace DJ;Clarke AE;Bernatsky S;Ginzler EM;Isenberg DA;Rahman A;Merrill JT;Alarcón GS;Fessler BJ;Fortin PR;Petri M;Steinsson K;Dooley MA;Khamashta MA;Ramsey-Goldman R;Zoma AA;Sturfelt GK;Nived O;Aranow C;Mackay M;Ramos-Casals M;van Vollenhoven RF;Kalunian KC;Ruiz-Irastorza G;Lim S;Kamen DL;Peschken CA;Inanc M;Urowitz MB
通讯作者：
Urowitz MB