OBJECTIVE: To study maternal and fetal outcome in women with past or present histologically proven systemic lupus erythematosus (SLE) nephritis. METHOD: Retrospective study of 32 pregnancies in 22 women with past or present histologically proven SLE nephritis in a single French centre. RESULTS: Pregnancy (25 planned and 7 not planned) occurred in a mean (SD) of 8 (5) years after SLE diagnosis and 6 (4) years after renal disease onset. Seven occurred in women with antiphospholipid syndrome. At pregnancy onset, all but one woman had creatininaemia below 100 micromol/l, five had proteinuria >0.5 g/day, none had hypertension. Twelve pregnancies occurred in women previously treated with immunosuppressant drugs. Treatment comprised prednisone (n=31), hydroxychloroquine (n=11), aspirin (n=22), heparin (n=12), and azathioprine in one patient with steroid resistant nephrotic syndrome disclosing SLE. No therapeutic abortion was done. During pregnancy or the postpartum period, or both, proteinuria >0.5 g/day occurred in 10 women (five related to pre-eclampsia, four to renal flare, one to stable nephrotic syndrome). One flare consisted of mild arthralgias. Pregnancy outcome comprised one feto-maternal death in SLE disclosed by pregnancy, five embryonic losses, two fetal deaths, and 18 premature (one neonatal death) and six full term births. No criterion appeared to influence fetal survival significantly. At long term, one patient died during an SLE flare, three women had renal relapses. At the last visit, all had creatininaemia below 100 micromol/l except one woman with creatinine level 115 micromol/l, nine had proteinuria >0.5 g/day, and one was treated for hypertension. CONCLUSION: Pregnancy need not be discouraged in women with a history of SLE nephritis with normal or mildly impaired renal function. Deterioration of renal function rarely occurs. However, these pregnancies are at high risk of pre-eclampsia and prematurity.
OBJECTIVE: To study maternal and fetal outcome in women with past or present histologically proven systemic lupus erythematosus (SLE) nephritis. METHOD: Retrospective study of 32 pregnancies in 22 women with past or present histologically proven SLE nephritis in a single French centre. RESULTS: Pregnancy (25 planned and 7 not planned) occurred in a mean (SD) of 8 (5) years after SLE diagnosis and 6 (4) years after renal disease onset. Seven occurred in women with antiphospholipid syndrome. At pregnancy onset, all but one woman had creatininaemia below 100 micromol/l, five had proteinuria >0.5 g/day, none had hypertension. Twelve pregnancies occurred in women previously treated with immunosuppressant drugs. Treatment comprised prednisone (n=31), hydroxychloroquine (n=11), aspirin (n=22), heparin (n=12), and azathioprine in one patient with steroid resistant nephrotic syndrome disclosing SLE. No therapeutic abortion was done. During pregnancy or the postpartum period, or both, proteinuria >0.5 g/day occurred in 10 women (five related to pre-eclampsia, four to renal flare, one to stable nephrotic syndrome). One flare consisted of mild arthralgias. Pregnancy outcome comprised one feto-maternal death in SLE disclosed by pregnancy, five embryonic losses, two fetal deaths, and 18 premature (one neonatal death) and six full term births. No criterion appeared to influence fetal survival significantly. At long term, one patient died during an SLE flare, three women had renal relapses. At the last visit, all had creatininaemia below 100 micromol/l except one woman with creatinine level 115 micromol/l, nine had proteinuria >0.5 g/day, and one was treated for hypertension. CONCLUSION: Pregnancy need not be discouraged in women with a history of SLE nephritis with normal or mildly impaired renal function. Deterioration of renal function rarely occurs. However, these pregnancies are at high risk of pre-eclampsia and prematurity.
Authors: E Imbasciati; M Surian; S Bottino; P Cosci; G Colussi; G C Ambroso; E Massa; L Minetti; G Pardi; C Ponticelli Journal: Nephron Date: 1984 Impact factor: 2.847
Authors: Miguel A Saavedra; Claudia Cruz-Reyes; Olga Vera-Lastra; Griselda T Romero; Polita Cruz-Cruz; Rafael Arias-Flores; Luis J Jara Journal: Clin Rheumatol Date: 2012-01-27 Impact factor: 2.980
Authors: Andrew Smyth; Guilherme H M Oliveira; Brian D Lahr; Kent R Bailey; Suzanne M Norby; Vesna D Garovic Journal: Clin J Am Soc Nephrol Date: 2010-08-05 Impact factor: 8.237
Authors: S J Wagner; I Craici; D Reed; S Norby; K Bailey; H J Wiste; C M Wood; K G Moder; K P Liang; K V Liang; C Rose; T Rozkos; M Sitina; J P Grande; V D Garovic Journal: Lupus Date: 2009-04 Impact factor: 2.911
Authors: George K Bertsias; Maria Tektonidou; Zahir Amoura; Martin Aringer; Ingeborg Bajema; Jo H M Berden; John Boletis; Ricard Cervera; Thomas Dörner; Andrea Doria; Franco Ferrario; Jürgen Floege; Frederic A Houssiau; John P A Ioannidis; David A Isenberg; Cees G M Kallenberg; Liz Lightstone; Stephen D Marks; Alberto Martini; Gabriela Moroni; Irmgard Neumann; Manuel Praga; Matthias Schneider; Argyre Starra; Vladimir Tesar; Carlos Vasconcelos; Ronald F van Vollenhoven; Helena Zakharova; Marion Haubitz; Caroline Gordon; David Jayne; Dimitrios T Boumpas Journal: Ann Rheum Dis Date: 2012-07-31 Impact factor: 19.103