Newton001 Pregnancy in Lupus: gestational, immunological and vascular risk factors and outcomes

当今巴西面临的两个最严重的健康问题是儿童死亡率和母亲死亡率，分别是英国的6倍和10倍。造成这种差异的原因是多方面的，但英国和巴西之间共享的知识可能会对这些数字产生可行的影响。系统性红斑狼疮(SLE)，通常被称为狼疮，是一种自身免疫性疾病，经常影响育龄妇女。当与妊娠叠加时，狼疮和狼疮样疾病(LLD)显著增加所有主要产科并发症的发生率，包括流产、死产、高血压、早产和胎儿生长受限。因此，这些妇女是一个主要的产科问题，无论她们的原籍国或临床环境如何。在临床上，对这一群体的最佳护理、治疗和监测仍在发展中。这项申请旨在通过英国和巴西之间积极的想法、研究和最佳实践的交流，协调和扩大这些怀孕研究和管理方面的研究/专业知识。该项目汇集了研究这些复杂妊娠的两个著名机构，一个在里约热内卢，另一个在曼彻斯特，两个机构都拥有丰富的产科和风湿病经验。在协调我们的研究工作时，我们的共同目标是更好地确定导致这些受影响妇女不良妊娠结局的关键血管、内分泌和免疫因素。通过标准化各中心的临床和研究方案，共享数据和研究样本，将加强当前的研究项目，并制定联合倡议。此外，通过最大限度地扩大各中心的临床实践，SLE/LLD患者根据怀孕风险进行分层的情况将得到改善，在患者护理和临床指南方面可能立即带来好处。

Two of the most serious health problems facing Brazil today are childhood and motherhood mortality, which outstrip the UK by 6- and 10 -fold, respectively. The reasons for this divide are multifactorial, but shared knowledge between the UK and Brazil could feasibly impact upon these figures. Systemic Lupus Erythematosus (SLE), often termed Lupus, is an autoimmune disorder that frequently affects women in their child-bearing years. When superimposed on pregnancy, Lupus and Lupus-like disorders (LLD) significantly increase the incidence of all major obstetric complications, including miscarriage, stillbirth, high blood pressure, premature birth and fetal growth restriction. These women are therefore a major obstetric concern, regardless of their country of origin or clinical setting. Clinically, the optimal care, treatment and monitoring of this group are still evolving. This application seeks to harmonise and expand the research/expertise in the study and management of these pregnancies, through the active exchange of ideas, research and best practice between the UK and Brazil. This project brings together two renowned facilities for the study of these complex pregnancies, one in Rio de Janeiro the other Manchester, both with a wealth of obstetric and rheumatology experience. In coordinating our research efforts, our joint aims are to better define the key vascular, endocrine and immunological factors which drive poor pregnancy outcome in these affected women. By standardising clinical and research protocols across centres, sharing data and study samples, current research projects will be enhanced and joint initiatives developed. Moreover, by maximising clinical practice across centres, the stratification of SLE/LLD patients according to their pregnancy risk will be improved, with potential immediate benefits in patient care and clinical guidelines.