Xinping Tian1, Mengtao Li1, Zhizhong Ye2, Xiao Zhang3, Shengyun Liu4, Lijun Wu5, Li Ma6, Liqi Bi7, Xiaoxia Zuo8, Lingyun Sun9, Cibo Huang10, Jiuliang Zhao1, Fengchun Zhang1, Yan Zhao1, Xiaofeng Zeng1. 1. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. 2. Department of Rheumatology, the Fourth People's Hospital of Shenzhen Affiliated to Guangdong Medical College, Shenzhen, China. 3. Department of Rheumatology, Guangdong Provincial People's Hospital, Guangzhou, China. 4. Department of Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 5. Department of Rheumatology, the People's Hospital of Xinjiang Autonomous, Urumqi, China. 6. Department of Rheumatology, China-Japan Friendship Hospital Affiliated to the Ministry of Health of PRC, Beijing, China. 7. Department of Rheumatology, Sino-Japanese friendship Hospital of Jilin University, Changchun, China. 8. Department of Rheumatology, Xiangya Hospital, Central South University, Changsha, China. 9. Department of Rheumatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. 10. Department of Rheumatology, Beijing Hospital Affiliated to the Ministry of Health of PRC, Beijing, China.
Abstract
OBJECTIVE: To study the factors associated with fetal loss in Chinese women with systemic lupus erythematosus (SLE) in a large cohort of SLE patients in the CSTAR (Chinese SLE Treatment and Research Group) registry. METHODS: We compared the clinical characteristics and auto-antibody profiles between SLE patients with fetal loss and SLE patients with normal pregnancies. The relationship between selected variables and fetal loss was examined by univariate analysis and binary logistic regression analysis. RESULTS: A total of 992 patients with 2026 pregnancies were recruited. Fifty women experienced fetal loss, including 49 spontaneous abortion, eight stillbirths and three neonatal deaths. The overall fetal loss rate was 3.0% (60/2026). Arthritis and serositis were observed significantly more frequently (P < 0.05) in normal pregnancy women. The rate of thrombocytopenia was significantly increased in patients with fetal loss (30.0% vs. 16.1%, P = 0.010), while there was no statistically significant difference in the frequency of nephropathy, central nervous system involvement between the normal pregnancy group and fetal loss group. Factors that associated with fetal loss included anti-phospholipid antibodies (aPL) (OR 2.299; 95% CI 1.058-4.993; P = 0.035) and anti-Sjögren syndrome antigen A (SSA) antibody (OR 2.283; 95% CI 1.275-4.088; P = 0.005), and thrombocytopenia (OR 2.241; 95% CI 1.192-4.213; P = 0.012). However, arthritis (OR 0.544, 95% CI 0.307-0.965, P = 0.037) was associated with favorable fetal outcome. CONCLUSIONS: Both univariate analysis and binary logistic regression analysis suggest that thrombocytopenia, aPL antibodies and anti-SSA antibody are associated with fetal loss in Chinese SLE women, while arthritis may be a possible factor related to favorable pregnancy outcome.
OBJECTIVE: To study the factors associated with fetal loss in Chinese women with systemic lupus erythematosus (SLE) in a large cohort of SLEpatients in the CSTAR (Chinese SLE Treatment and Research Group) registry. METHODS: We compared the clinical characteristics and auto-antibody profiles between SLEpatients with fetal loss and SLEpatients with normal pregnancies. The relationship between selected variables and fetal loss was examined by univariate analysis and binary logistic regression analysis. RESULTS: A total of 992 patients with 2026 pregnancies were recruited. Fifty women experienced fetal loss, including 49 spontaneous abortion, eight stillbirths and three neonatal deaths. The overall fetal loss rate was 3.0% (60/2026). Arthritis and serositis were observed significantly more frequently (P < 0.05) in normal pregnancy women. The rate of thrombocytopenia was significantly increased in patients with fetal loss (30.0% vs. 16.1%, P = 0.010), while there was no statistically significant difference in the frequency of nephropathy, central nervous system involvement between the normal pregnancy group and fetal loss group. Factors that associated with fetal loss included anti-phospholipid antibodies (aPL) (OR 2.299; 95% CI 1.058-4.993; P = 0.035) and anti-Sjögren syndrome antigen A (SSA) antibody (OR 2.283; 95% CI 1.275-4.088; P = 0.005), and thrombocytopenia (OR 2.241; 95% CI 1.192-4.213; P = 0.012). However, arthritis (OR 0.544, 95% CI 0.307-0.965, P = 0.037) was associated with favorable fetal outcome. CONCLUSIONS: Both univariate analysis and binary logistic regression analysis suggest that thrombocytopenia, aPL antibodies and anti-SSA antibody are associated with fetal loss in Chinese SLEwomen, while arthritis may be a possible factor related to favorable pregnancy outcome.