METHODS: We conducted a retrospective review (2006-2019) of pregnancy outcomes among patients with SLE (n = 51) and UCTD (n = 20) within our institution. We examined the occurrence of various APOs, encompassing miscarriage, stillbirth, termination, preterm birth, pre-eclampsia, eclampsia, HELLP syndrome, intrauterine growth restriction, abruption placentae, congenital heart block, or other cardiac abnormalities.
RESULTS: The mean age at pregnancy was 35 ± 7.0 years for patients with SLE and 35 ± 6.8 years for those with UCTD (p = 0.349). The proportion of Caucasian women was 47% in SLE and 80% in UCTD. Pregnancies in both groups were planned (81% in SLE and 77% in UCTD), and patients presented with inactive disease at conception (96% in SLE and 89% in UCTD). Hydroxychloroquine at conception was utilized by 86% of women with SLE, in contrast to 36% in the UCTD group. Both, SLE and UCTD cohorts exhibited low rates of disease flares during pregnancy and/or puerperium (14% vs. 10%). The incidence of APOs was 15.6% in SLE patients compared to 5% in those with UCTD (Risk difference 19.5%; 95% confidence interval: -3.9 to 43.1; p = 0.4237).
CONCLUSIONS: Our study underscores the importance of strategic pregnancy planning and the maintenance of appropriate treatment throughout pregnancy to ensure optimal disease management and minimize adverse outcomes in both SLE and UCTD pregnancies.
方法:我们对我们机构内SLE(n=51)和UCTD(n=20)患者的妊娠结局进行了回顾性回顾(2006-2019)。我们检查了各种APO的发生,包括流产,死产,终止,早产,先兆子痫,子痫,HELLP综合征,宫内生长受限,胎盘早剥,先天性心脏传导阻滞,或其他心脏异常。
结果:SLE患者的妊娠平均年龄为35±7.0岁,UCTD患者为35±6.8岁(p=0.349)。SLE和UCTD中白种人女性的比例分别为47%和80%。两组均计划怀孕(SLE为81%,UCTD为77%),患者在受孕时表现为非活动性疾病(SLE为96%,UCTD为89%)。86%的SLE女性在怀孕时使用羟氯喹,与UCTD组的36%相反。两者,SLE和UCTD队列在怀孕和/或产褥期出现疾病耀斑的发生率较低(14%vs.10%)。SLE患者的APO发生率为15.6%,而UCTD患者为5%(风险差异19.5%;95%置信区间:-3.9至43.1;p=0.4237)。
结论:我们的研究强调了战略性妊娠计划和在整个妊娠期间维持适当治疗的重要性,以确保SLE和UCTD妊娠的最佳疾病管理并最大程度地减少不良结局。