Risk factors associated with adverse pregnancy outcomes in patients with new-onset systemic lupus erythematosus during pregnancy

摘要

Objective To investigate the risk factors for Adverse pregnancy outcome (APOs) in patients with new-onset SLE during pregnancy. Methods Eighty-five patients with new-onset SLE during pregnancy were analyzed retrospectively. Univariate and multivariate logistic regression were used to identify risk factors for different APOs (pregnancy loss, preterm birth, fetal growth restriction, and eclampsia/preeclampsia). A two-sided p-value below 0.05 was considered significant, and two-sided 95% confidence intervals (CIs) are reported. Results Multivariate analysis indicated that renal involvement (aOR: 7.356 ; 95%CI: 1.516,35.692 ) and greater SLE disease activity index (SLEDAI) grade (aOR: 5.947 ;95%CI: 1.586,22.294 ) increased the risk for composite APO, and that use of heparin therapy (aOR: 0.081; 95%CI: 0.012, 0.532) was a protective factor. Advanced gestational age at disease onset (aOR: 0.879 ; 95%CI: 0.819,0.943 ) and high serum albumin level (aOR: 0.908 ,95%CI: 0.831,0.992 ) protected against pregnancy loss. Renal involvement increased the risk for preterm birth (aOR: 2.272 ; 95%CI: 1.030,7.222 ) and fetal growth restriction (aOR: 9.070 ; 95%CI: 1.131,72.743 ). Hypertension (aOR: 19.185 ; 95%CI: 3.921,93.868 ), renal involvement (aOR: 8.380 , 95%CI: 1.944,74.376 ) increased the risk for eclampsia/preeclampsia. Conclusion New onset SLE during pregnancy increased the risk for multiple APOs. Timely management of the risk factors identified here may help to improve pregnancy outcomes in these patients.