OBJECTIVE: To compare rates and predictors of pregnancy complications in mothers with systemic lupus erythematosus (SLE) with and without previous nephritis (PN). METHODS: Retrospective analysis of 107 pregnancies in 83 women with SLE diagnosed prepregnancy. RESULTS: Mothers with PN had higher rates of preterm delivery (< 37/40, 30% vs 11%, p = 0.029) than those without PN. Women with PN had earlier onset of preeclampsia [median 34.5 weeks (IQR 32-37) vs 37.5 weeks (IQR 35-38, p = 0.047)] that was more frequently complicated by preterm delivery (p = 0.02). Risk factors for preeclampsia in women with PN include 10-13 weeks' gestation diastolic blood pressure > 80 mmHg and proteinuria, and prepregnancy estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m(2). In women with PN, midtrimester uterine-artery-Doppler notching had low negative predictive value (47%). After 39 months followup, eGFR was stable in women with or without PN. CONCLUSION: In SLE, preterm deliveries are more frequent and preeclampsia occurs earlier in women with PN, but longterm eGFR is preserved.
OBJECTIVE: To compare rates and predictors of pregnancy complications in mothers with systemic lupus erythematosus (SLE) with and without previous nephritis (PN). METHODS: Retrospective analysis of 107 pregnancies in 83 women with SLE diagnosed prepregnancy. RESULTS: Mothers with PN had higher rates of preterm delivery (< 37/40, 30% vs 11%, p = 0.029) than those without PN. Women with PN had earlier onset of preeclampsia [median 34.5 weeks (IQR 32-37) vs 37.5 weeks (IQR 35-38, p = 0.047)] that was more frequently complicated by preterm delivery (p = 0.02). Risk factors for preeclampsia in women with PN include 10-13 weeks' gestation diastolic blood pressure > 80 mmHg and proteinuria, and prepregnancy estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m(2). In women with PN, midtrimester uterine-artery-Doppler notching had low negative predictive value (47%). After 39 months followup, eGFR was stable in women with or without PN. CONCLUSION: In SLE, preterm deliveries are more frequent and preeclampsia occurs earlier in women with PN, but longterm eGFR is preserved.
Authors: Jill P Buyon; Mimi Y Kim; Marta M Guerra; Sifan Lu; Emily Reeves; Michelle Petri; Carl A Laskin; Michael D Lockshin; Lisa R Sammaritano; D Ware Branch; T Flint Porter; Allen Sawitzke; Joan T Merrill; Mary D Stephenson; Elisabeth Cohn; Jane E Salmon Journal: Clin J Am Soc Nephrol Date: 2017-04-11 Impact factor: 8.237
Authors: Jill P Buyon; Mimi Y Kim; Marta M Guerra; Carl A Laskin; Michelle Petri; Michael D Lockshin; Lisa Sammaritano; D Ware Branch; T Flint Porter; Allen Sawitzke; Joan T Merrill; Mary D Stephenson; Elisabeth Cohn; Lamya Garabet; Jane E Salmon Journal: Ann Intern Med Date: 2015-08-04 Impact factor: 25.391