Pregnancy Outcomes in a Diverse US Lupus Cohort.
Pregnancy Outcomes in a Diverse US Lupus Cohort.
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美国不同狼疮队列的妊娠结果。
DOI：
10.1002/acr.25279
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发表时间：
2024
影响因子：
4.7
通讯作者：
Hedderson,MoniqueM
中科院分区：
文献类型：
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作者：
Simard,JuliaF;Liu,EmilyF;Chakravarty,Eliza;Rector,Amadeia;Cantu,Miranda;Kuo,DanielZ;Shaw,GaryM;Druzin,MauriceL;Weisman,MichaelH;Hedderson,MoniqueM
尽管系统性红斑狼疮（SLE）患者人群在种族和人种上是多样化的，但许多研究人群是同质的。此外，数据往往缺乏关键因素，如抗磷脂抗体（aPL）。我们调查了活产率与SLE患者在凯泽永久北方加州，包括种族和民族和aPL data.MethodsElectronic健康记录的妊娠结果观察2011年至2020年确定SLE患者。流行性SLE定义为末次月经前间隔7天或7天以上的两次或两次以上国际疾病分类编码的就诊。我们总结了患者特征、用药医嘱、医疗保健使用和药物使用。妊娠结局（活产，死产，自然流产，异位妊娠，葡萄胎妊娠），提出了整体和分层的种族和民族，aPL状态，肾炎history.ResultsWe确定了657例妊娠453例SLE患者。该队列具有多样性，反映了北方加州人群（27%为亚洲人，26%为西班牙裔，26%为非西班牙裔白色人，13%为非西班牙裔黑人，5%为多种族，约2%为太平洋岛民和美洲原住民）。在观察到的妊娠中，约74%以活产结束，23%导致自然流产，2%为异位妊娠或葡萄胎妊娠，<1%为死产。有有限的变化，活产的种族和民族（72%-79%），aPL状态（69.5%-77%），和肾炎的历史（71%-75%）。ConclusionOur研究结果与以前的研究是一致的，但是，一些方法的差异可能会产生一系列的活产率。我们发现，SLE患者中约74%的妊娠以活产结束，自然流产在人种和种族、肾炎病史和aPL状态方面存在适度差异。
ObjectiveAlthough the population of patients with systemic lupus erythematosus (SLE) is racially and ethnically diverse, many study populations are homogeneous. Further, data are often lacking on critical factors, such as antiphospholipid antibodies (aPLs). We investigated live birth rates in patients with SLE at Kaiser Permanente Northern California, including race and ethnicity and aPL data.MethodsElectronic health records of pregnancies with outcomes observed from 2011 to 2020 were identified among patients with SLE. Prevalent SLE was defined as two or moreInternational Classification of Diseases–coded visits seven or more days apart before the last menstrual period. We summarized patient characteristics, medication orders, health care use, and medication use. Pregnancy outcomes (live birth, stillbirth, spontaneous abortion, ectopic pregnancy, and molar pregnancy) were presented overall and stratified by race and ethnicity, aPL status, and nephritis history.ResultsWe identified 657 pregnancies among 453 patients with SLE. The cohort was diverse, reflecting the Northern California population (27% Asian, 26% Hispanic, 26% Non‐Hispanic White, 13% Non‐Hispanic Black, 5% multiracial, and approximately 2% Pacific Islander and Native American). Approximately 74% of observed pregnancies ended in live birth, 23% resulted in spontaneous abortion, 2% were ectopic or molar pregnancies, and <1% were stillbirths. There was limited variability in live births by race and ethnic group (72%–79%), aPL status (69.5%–77%), and nephritis history (71%–75%).ConclusionOur findings are consistent with previous studies; however, some methodologic differences may yield a range of live birth rates. We found that approximately 74% of pregnancies in patients with SLE ended in live birth, with modest variability in spontaneous abortion by race and ethnicity, nephritis history, and aPL status.