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Preeclampsia in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

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Abstract

Objectives

The impact of systemic lupus erythematosus (SLE) on preeclampsia is still obscure. This study was performed to systematically assess the association between preeclampsia and SLE.

Method

According to the PRISMA statement, designed literature research was performed in PubMed, Web of Science, and Cochrane Library from inception to June 30, 2018. The pooled risk ratio (RR) of preeclampsia in pregnant SLE patients compared with health controls was synthesized by fixed effect model or random effects model depending on heterogeneity.

Results

Ten studies involving 6,389 SLE patients were included. Pregnant women with SLE have significantly increased risk of preeclampsia (RR = 2.99, 95% CI = 2.31 to 3.88; Z = 8.31, P < 0.001) compared with health controls. Subgroup analysis showed that the risk of preeclampsia was significant (Q = 7.64, P = 0.006) higher in prospective studies (RR = 6.94, 95% CI = 3.59 to 13.42) compared to retrospective studies (RR = 2.60, 95% CI = 2.08 to 3.25).

Conclusions

The present study demonstrated that pregnant SLE patients have a high risk of preeclampsia, suggesting a pivotal role of SLE in the pathogenesis of preeclampsia. For rheumatologists and SLE patients, it is important to maintain inactive disease activity and prevent complications as LN, and the control of traditional risk factors of preeclampsia is also pivotal. Further study focus on the prevention of preeclampsia in SLE is also urgent.

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Acknowledgments

This study was supported by Grants National Natural Science Foundation of China (No. 81573217). We also appreciate the efforts of all the researchers whose articles were included in this study.

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Author notes

  1. Yuanyuan Dong and Feifei Yuan are contributed equally to this work and joint first authors.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China

    Yuanyuan Dong, Feifei Yuan, Ziwei Dai, Zhihui Wang & Bin Wang

  2. The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China

    Yuanyuan Dong, Feifei Yuan, Ziwei Dai, Zhihui Wang & Bin Wang

  3. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, Anhui, China

    Ying Zhu

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  1. Yuanyuan Dong
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Correspondence to Bin Wang.

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Dong, Y., Yuan, F., Dai, Z. et al. Preeclampsia in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis. Clin Rheumatol 39, 319–325 (2020). https://doi.org/10.1007/s10067-019-04823-8

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