RHEUMATOLOGY / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Systemic lupus erythematosus (SLE) is a prototypic autoimmune disorder with a variable clinical course, ranging from mild to severe forms. It mainly occurs in women, especially those of fertile age. The aim of the study was to systematically analyze the associations of perinatal disease activity with adverse outcomes of Chinese patients with SLE and their off-spring.

Material and methods:
Data of prenatal SLE patients and healthy pregnant woman admitted to our hospital during the period October 2001 to January 2018 were retrospectively collected, and the status of offspring of SLE patients was followed up in March 2020. Disease activity was evaluated by SLE disease activity index 2000 (SLEDAI-2k), and those with scores > 6 were defined as having active disease.

Results:
In total, 198 deliveries of 194 SLE patients and 199 deliveries of healthy women were documented. Maternal and fetal adverse outcomes occurred in 74 (37.4%) and 90 (45.5%) deliveries of SLE patients, respectively, which were significantly higher than those of healthy subjects. Among SLE patients, the active group had higher rates of gestational hypertension (p < 0.001), reeclampsia/eclampsia (p < 0.001), low birth weight (p < 0.001), premature birth (p < 0.001) and fetal growth restriction (FGR) (p < 0.01) than the inactive group. Multivariate logistic analysis revealed that perinatal renal activity was associated with gestational hypertension (OR 4.43, p < 0.001), preeclampsia/ eclampsia (OR 9.14, p < 0.001), low birth weight (OR 2.24, p < 0.05) and premature birth (OR 4.20, p < 0.001). Compared with the general population, offspring of SLE patients had relatively high rates of eczema (50/142, 35.2%) and congenital heart disease (6/142, 4.2%), which were irrelevant to perinatal disease activity, but related to specific antibodies.

Conclusions:
For perinatal women with SLE, renal activity is associated with a variety of adverse pregnancy outcomes. However, maternal perinatal disease activity does not seem to affect the growth of their offspring

 
REFERENCES (37)
1.
Sam NB, Guan SY, Wang P, et al. Levels of the macrophage migration inhibitory factor and polymorphisms in systemic lupus erythematosus: a meta-analysis. Arch Med Sci 2021; 17: 1232-40.
 
2.
Wang G, Zhuo N, Tian F, Li J, Wen Z. Two complications in patients with systemic lupus erythematosus: lupus cystitis and lupus enteritis. Arch Med Sci 2022; 18: 822-4.
 
3.
Normand G, Sens F, Puthet J, et al. Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus. Lupus 2019; 28: 529-37.
 
4.
Ku M, Guo S, Shang W, et al. Pregnancy outcomes in chinese patients with systemic lupus erythematosus (SLE): a retrospective study of 109 pregnancies. PLoS One 2016, 11: e0159364.
 
5.
Naseri EP, Surita FG, Borovac-Pinheiro A, Santos M, Appen­zeller S, Costallat LTL. Systemic lupus erythematosus and pregnancy: a single-center observational study of 69 pregnancies. Rev Bras Ginecol Obstet 2018; 40: 587-92.
 
6.
Deguchi M, Maesawa Y, Kubota S, et al. Factors associated with adverse pregnancy outcomes in women with systematic lupus erythematosus. J Reprod Immunol 2018; 125: 39-44.
 
7.
Lateef A, Petri M. Systemic lupus erythematosus and pregnancy. Rheum Dis Clin North Am 2017; 43: 215-26.
 
8.
Palma Dos Reis CR, Cardoso G, Carvalho C, Nogueira I, Borges A, Serrano F. Prediction of adverse pregnancy outcomes in women with systemic lupus erythematosus. Clin Rev Allergy Immunol 2020; 59: 287-94.
 
9.
Andreoli L, Bertsias GK, Agmon-Levin N, et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 2017; 76: 476-85.
 
10.
Ko HS, Ahn HY, Jang DG, et al. Pregnancy outcomes and appropriate timing of pregnancy in 183 pregnancies in Korean patients with SLE. Int J Med Sci 2011; 8: 577-83.
 
11.
Stanhope TJ, White WM, Moder KG, Smyth A, Garovic VD. Obstetric nephrology: lupus and lupus nephritis in pregnancy. Clin J Am Soc Nephrol 2012; 7: 2089-99.
 
12.
Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271-7.
 
13.
Gladman DD, Ibanez D, Urowitz MB. Systemic lupus eryt­hematosus disease activity index 2000. J Rheumatol 2002; 29: 288-91.
 
14.
Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019; 78: 736-45.
 
15.
Zong XN, Li H, Zhang YQ, Wu HH. Child nutrition to new stage in China: evidence from a series of national surveys, 1985-2015. BMC Public Health 2019; 19: 402.
 
16.
Wu J, Hu Y, Li M, et al. Prevalence of anemia in Chinese children and adolescents and its associated factors. Int J Environ Res Public Health 2019; 16: 1416.
 
17.
Ross G, Sammaritano L, Nass R, Lockshin M. Effects of mothers’ autoimmune disease during pregnancy on learning disabilities and hand preference in their children. Arch Pediatr Adolesc Med 2003; 157: 397-402.
 
18.
Liu F, Ma HW, Dai XM, Tian XB, Wang LB, Ma J. Compa­rative study on sensory integration function in children with primary nocturnal enuresis. Zhongguo Dang Dai Er Ke Za Zhi 2010; 12: 341-3.
 
19.
Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 2006; 368: 733-43.
 
20.
Aung YM, Jelleyman T, Ameratunga S, Tin Tin S. Body mass index and dental caries in New Zealand pre-school children: a population-based study. J Paediatr Child Health 2021; 57: 1432-7.
 
21.
Makris M, Koulouris S, Koti I, et al. Temporal relationship of allergic rhinitis with asthma and other co-morbidities in a Mediterranean country: a retrospective study in a tertiary reference allergy clinic. Allergol Immunopathol (Madr) 2010; 38: 246-53.
 
22.
Zahari N, Mat Bah MN, Razak HA, Thong MK. Ten-year trend in prevalence and outcome of Down syndrome with congenital heart disease in a middle-income country. Eur J Pediatr 2019; 178: 1267-74.
 
23.
Zhao MC, Guo YH, Qiu FZ, et al. Molecular and clinical characterization of human adenovirus associated with acute respiratory tract infection in hospitalized children. J Clin Virol 2020; 123: 104254.
 
24.
Dong Y, Jan C, Ma Y, et al. Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys. Lancet Diabetes Endocrinol 2019; 7: 288-299.
 
25.
Yao B, Wu HR. Risk factors of learning disabilities in Chinese children in Wuhan. Biomed Environ Sci 2003; 16: 392-7.
 
26.
Song N, Shamssain M, Zhang J, et al. Prevalence, seve­rity and risk factors of asthma, rhinitis and eczema in a large group of Chinese schoolchildren. J Asthma 2014; 51: 232-42.
 
27.
Gu ZW, Zhang SS, Zhang RJ, et al. Prevalence of caries in mainland China: evidence from 1980 to 2018: a systematic review and meta-analysis. Chin J Dent Res 2019; 22: 251-63.
 
28.
Qu Y, Liu X, Zhuang J, et al. Incidence of congenital heart disease: the 9-year experience of the Guangdong registry of congenital heart disease, China. PLoS One 2016; 11: e0159257.
 
29.
Vinet E, Pineau CA, Clarke AE, et al. Increased risk of autism spectrum disorders in children born to women with systemic lupus erythematosus: results from a large population-based cohort. Arthritis Rheumatol 2015; 67: 3201-8.
 
30.
Yousef Yengej FA, Van Royen-Kerkhof A, Derksen R, Fritsch-Stork RDE. The development of offspring from mothers with systemic lupus erythematosus. A syste­matic review. Autoimmun Rev 2017; 16: 701-11.
 
31.
Couture J, Ben-Shoshan M, Pineau CA, et al. Risk of allergic conditions in children born to women with systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2018; 70: 315-9.
 
32.
Vinet E, Pineau CA, Scott S, Clarke AE, Platt RW, Bernatsky S. Increased congenital heart defects in children born to women with systemic lupus erythematosus: results from the offspring of Systemic Lupus Erythematosus Mothers Registry Study. Circulation 2015; 131: 149-56.
 
33.
Urowitz MB, Gladman DD, Mackinnon A, et al. Neurocognitive abnormalities in offspring of mothers with systemic lupus erythematosus. Lupus 2008; 17: 555-60.
 
34.
Neri F, Chimini L, Bonomi F, et al. Neuropsychological development of children born to patients with systemic lupus erythematosus. Lupus 2004; 13: 805-11.
 
35.
Davidov D, Sheiner E, Wainstock T, Miodownik S, Pariente G. Maternal systemic lupus erythematosus (SLE) high risk for preterm delivery and not for long-term neurological morbidity of the offspring. J Clin Med 2021; 10: 2952.
 
36.
Knudsen SS, Simard JF, Knudsen JS, et al. Systemic lupus erythematosus during pregnancy is not associated with school performance in offspring – a Danish population-based study. Lupus 2021; 30: 228-37.
 
37.
Higashi N, Kawana S. Atopic eczema complicated by systemic lupus erythematosus. Eur J Dermatol 2005; 15: 500-2.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top