Clinical Analysis Of 91 Cases Of Pregnancy Complicated With Systemic Lupus Erythematosus

Objective:To investigate the clinical characteristics and pregnancy outcomes of pregnancies with systemic lupus erythematosus(SLE).and explore the risk factors of fetal loss.Materials and Methods:91 pregnancies in 88 SLE patients treated between September 2013 and September 2018 in the first affiliated hospital of fujian medical university were case group.And 103 cases over the same period in patients without SLE were control group.The clinical data were retrospectively analyzed.According to SLEDAI,the case group was divided into the A group(SLEDAI≤9)and the B group(SLE>9).The pregnancy outcomes,fetal outcomes,and laboratory reportduring pregnancy were compared between the groups.Results:1.In the case group,the percentages of live birth were significantly lower than those in the control group,and the premature birth,fetal loss,fetal intrauterine anoxia,placental abruption,preeclampsia were higher those in those in the control group.Compared with the B group,the live birth rate increased and premature birth,fetal loss,fetal intrauterine anoxia,placental abruption,preeclampsia decreased in the A group.2.Cesarean section rate was higher in the case group than in the control group,(78.6% VS 43.2%,P=0.000 < 0.05).And the disease activity did not effecting cesarean section rate.Cesarean section rate was not significantly different between the A group and B group(P=0.145>0.05).3.To analyzing the test results in the pregnancy between groups.We found that blood platelets,serum albumin were clearly below in the case group than in the control group(P=0.023、0.00<0.05),and the Serum creatinine,Uric acid,Urine protein were significantly higher than in the control group(P=0.003、0.004、0.000<0.05),two groups of patients compared statistically significant difference(P<0.05).4.In the case group,36 newborns(51.4%)were changed to neonatology department,including 24 newborns(66.7%)getting infection.And there were 11 newborns(15.7%)min Apgar score less than 10 points in the case group.However in the control group,21 newborns(21.6%)were changed to neonatology department,including 7 newborns(33.3%)getting infection.And there were 6 newborns(6.2%)min Apgar score less than 10 points in the case group.The rates of newborns changing department,neonatal infection and low apgar scores in the case group clearly higher than those of the control group(P <0.05).Average birth weight in the case group was 2878.6±573.9g,which lower than the average birth weight of the control group(3309.5±463.0g),P=0.000<0.05.5.To explore the reason of the pregnancy loss,we found that albuminuria was an independent risk factor of pregnancy loss for the patient pregnancy with SLE.Conclusion:1.Pregnancy in women with SLE is a high-risk condition,and care should be closely coordinated between the obstetrician and rheumatologist.2.Disease flare leads to increased risk of adverse pregnancy outcomes,such as preeclampsia,premature birth and so on.Close monitoring,tailored multidisciplinary care,and judicious use of medications are the key to achieve optimal outcomes.3.Neonatal infection was more likely to occur in pregnant women with SLE,and the newborns need special care.Thus,we should closely monitor the neonatal vital signs.If necessary,the baby should be transferred to neonatal department for further treatment.4.The albuminuria was an independent risk factor of pregnancy loss for the patient pregnant with SLE.Reinforce the intensive care during the perinatal period is important for the patient.When we find abnormal laboratory values,such as albuminuria,thrombocytopenia,hyperuricemia and so on,the patient might consider shortening the relevant interval.