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Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy

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Abstract

Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and without previous lupus nephritis. We analyzed the clinical records of pregnant SLE patients attended in a tertiary reference center during a 5-year period. Patients were allocated into two groups according to the presence or absence of previous lupus nephritis. Women were evaluated monthly during pregnancy and at least 1 month postpartum. Maternal and fetal outcomes of pregnancy were abstracted. We included 95 pregnancies in 92 patients. Compared with pregnant women without lupus nephritis (n = 60), pregnancies with previous lupus nephritis (n = 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%, p = 0.00001), higher rate of lupus flares (54.2% vs. 25%, p = 0.004), and renal flares (45.7% vs. 6.6%, p = 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups.

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Authors and Affiliations

  1. Rheumatology Department, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Mexico City, Mexico

    Miguel A. Saavedra & Claudia Cruz-Reyes

  2. Internal Medicine Department, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Mexico City, Mexico

    Olga Vera-Lastra

  3. Education and Research Division, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Mexico City, Mexico

    Griselda T. Romero & Luis J. Jara

  4. Obstetric and Gynecology, Hospital de Gineco-Obstetricia No. 3, Centro Médico Nacional “La Raza”, Mexico City, Mexico

    Polita Cruz-Cruz

  5. Epidemiology Division, Hospital de Pediatría, Centro Médico Nacional siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Rafael Arias-Flores

  6. Universidad Nacional Autónoma de México, Mexico City, Mexico

    Miguel A. Saavedra, Olga Vera-Lastra & Luis J. Jara

Authors
  1. Miguel A. Saavedra
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  2. Claudia Cruz-Reyes
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  3. Olga Vera-Lastra
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  4. Griselda T. Romero
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  5. Polita Cruz-Cruz
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  6. Rafael Arias-Flores
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  7. Luis J. Jara
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Correspondence to Luis J. Jara.

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Saavedra, M.A., Cruz-Reyes, C., Vera-Lastra, O. et al. Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy. Clin Rheumatol 31, 813–819 (2012). https://doi.org/10.1007/s10067-012-1941-4

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  • DOI: https://doi.org/10.1007/s10067-012-1941-4

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