Characteristics And Outcome Of Pregnancy In The Second Birth Of Systemic Lupus Erythematosus In A Single Center(Analysis Of 34 Cases)

【Objective】 To investigate the risk and outcome of second pregnancy in lupus erythematosus patients by reviewing and analyzing the data of systemic lupus erythematosus(Systemic Lupus Erythematosus,SLE)and normal second parity pregnancy treated in our center since the opening of the national two-child policy.Whether planned pregnancy leads to different changes in the condition and different maternal and infant outcomes during pregnancy.【Methods】We retrospectively analyzed the clinical material of 34 cases patients with systemic lupus erythematosus during pregnancy,who hospitalized in The Second Attached Hospital Of Fujian Medical University during November 2015 to January 2019.According to the timing of pregnancy,they were divided into planned pregnancy group and unplanned pregnancy group.the general situation,clinical manifestations,disease activity,maternal and infant pregnancy outcomes and complications,and delivery methods before the end of pregnancy were compared between the two groups.At the same time,120 women without connective tissue disease who gave birth to a second child in The Second Affiliated Hospital of Fujian Medical University from March 01,2017 to March 15,2017 were selected as the control group.The maternal and infant outcomes of the control group and the SLE pregnancy group were compared and statistically analyzed.【Results】The main clinical manifestations of SLE activity during pregnancy were skin,mucosa and renal system.2 patients(9.5%)of planned pregnant group occurred disease progression while 7 patients(53.8%)of unplanned pregnant group having the same change,and the difference had statistical significance(p<0.05).In terms of pregnancy outcome,In the unplanned pregnancy group,there were 6 cases of premature delivery(46.2%),6 cases of low birth weight(46.2%)and 4 cases of preeclampsia(30.8%).The results of the above pregnancy outcomes in the planned pregnancy group were 4 cases(19%),2 cases(9.5%)and 0 cases(0.0%),respectively.there was a significant difference between the two groups(p<0.05).In the normal control group,there were 14 cases of premature delivery(11.7%),7 cases of low birth weight(5.8%)and 5 cases of preeclampsia(4.2%).The incidence of pregnancy outcome above in the normal control group was significantly lower than that in the unplanned pregnancy group(p<0.05),and there were no difference between the planned pregnant group and the normal control group.【Conclusion】1、Both planned and unplanned pregnancy patients with SLE are at risk of lupus activity and poor maternal and infant outcomes during pregnancy.2、In order to ensure a good pregnancy outcome,planned pregnancy in SLE women at the controlled and remission stages of SLE is expected to reduce complications.3、This study suggests that the pregnancy management gate of SLE patients should be moved forward,planning pregnancy on the premise of excluding pregnancy contraindications.Careful preconception planning,assessment of risk factors,and be included in the targeted management at different stages before,during and after pregnancy.We believe that close management and monitoring of both the disease and the health of the fetus can help achieve better outcomes for mother and baby.