Analysis Of Maternal And Infant Outcomes In Pregnancy Complicated With Systemic Lupus Erythematosus

Objectives:To study the disease activity,pregnancy outcome and obstetric complications in patients with systemic lupus erythematosus and propose appropriate timing for conception.Methods:A retrospective analysis of 158 cases of pregnancies with SLE hospitalized in our hospital from January 2019 to December 2021 was grouped according to SLE activity score: pregnancy group(n=74): 4 SLEDA score(no cytotoxic medication for at least half a year after treatment and no cytotoxic application and oral prednisone5-15 mg / d).Non-selected pregnancy group(n=84): SLEDA score> 5(including first pregnancy and diagnosed without being assessed by the doctor).Contrast the two groups The general data,symptoms and signs,examination and examination results,gestational pregnancy week,pregnancy outcome,delivery mode and neonatal condition were analyzed and summarized.Results:1.General data of non-selective pregnancy and selective pregnancy groups:mean age:(26.53 ± 4.29)vs(25.36 ± 3.07)years,mean disease duration:(4.02 ± 0.50)vs(3.70 ± 0.40)years,mean pregnancy:(1.81 ± 0.10)vs(1.63 ± 0.10),respectively(P> 0.05).2.Comparison of clinical manifestations between non-selective pregnancy groups and selective pregnancy groups: lupus nephritis:(23.0%vs8.3%),skin damage:(50.0%vs17.9%),the quantitative urine protein increased:(59.4%vs23.8%);statistically significant(P <0.05).Fever:(31.1%vs36.9%);arthritis:(9.5%vs3.6%);anemia,thrombocytopenia:(18.9%vs23.8%),not statistically significant(P> 0.05).3.Non-selective pregnancy and selective pregnancy immunization: positive anti-RNP antibody:(18.9%vs23.8%);3.8% difference(P> 0.05),complement C3 and C4 decreased:(51.4%vs23.8%);ds DNA antibody titer;(62.2%vs33.3%);ESR:(40.5%vs11.9%);between both groups(P <0.05).4.Non-selective pregnancy group and selective pregnancy medication comparison: non-selective pregnancy group hydroxychloroquine + glucocorticoid combination application: no activity: mild activity: moderate activity: severe activity(17.6%vs51.4%vs21.6%vs9.5%);selective pregnancy group hydroxychloroquine +glucocorticoid combination application: no activity: mild activity: moderate activity:severe activity(72.6%vs19.0%vs.8.3%vs0.0%);hydroxychloroquine + glucocorticoid combination,selective pregnancy group higher than the nonselective pregnancy group,a statistically significant difference(P <0.05).5.Comparison of pregnancy complications between the non-selective pregnancy group and the selective pregnancy group: PROM:(70.6%vs29.4%);preeclampsia +gestational hypertension:(88.9%vs11.1%);significant difference(P <0.05).6.Comparing pregnancy outcomes between non-selective pregnancy group and selective pregnancy group:pregnancy loss: non-selective pregnancy group(therapeutic abortion,spontaneous abortion,stillbirth: 13.5%vs6.8%vs6.8%);selective pregnancy group(therapeutic abortion,spontaneous abortion,stillbirth:7.1%vs4.8%vs0.0%);no statistical difference(P> 0.05).Live birth: non-selective pregnancy group(preterm birth,term birth: 59.5%vs13.5%);elective pregnancy group(preterm birth,term birth: 28.6%vs59.5%);significant difference(P <0.05).7.Non-selective pregnancy group patients and selective pregnancy group in childbirth mode: natural delivery:(30.8%vs69.2%);cesarean section:(62.5%vs37.5%);X2 value =16.0,P value =0.001,which is statistically significant(P <0.05).The main indication for cesarean delivery was SLE activity.Conclusion:Female patients with SLE can have better maternal and infant pregnancy outcomes with stable SLE activity(SLEDA score)4.