Yuanyuan Dong1,2, Feifei Yuan1,2, Ziwei Dai1,2, Zhihui Wang1,2, Ying Zhu3, Bin Wang4,5. 1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. 2. The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. 3. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, Anhui, China. 4. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. wangbin@ahmu.edu.cn. 5. The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. wangbin@ahmu.edu.cn.
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.
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.
Authors: Eliza F Chakravarty; Iris Colón; Elizabeth S Langen; David A Nix; Yasser Y El-Sayed; Mark C Genovese; Maurice L Druzin Journal: Am J Obstet Gynecol Date: 2005-06 Impact factor: 8.661
Authors: Julia F Simard; Elizabeth V Arkema; Cathina Nguyen; Elisabet Svenungsson; Anna-Karin Wikström; Kristin Palmsten; Jane E Salmon Journal: Paediatr Perinat Epidemiol Date: 2016-12-12 Impact factor: 3.980
Authors: Ben W J Mol; Claire T Roberts; Shakila Thangaratinam; Laura A Magee; Christianne J M de Groot; G Justus Hofmeyr Journal: Lancet Date: 2015-09-02 Impact factor: 79.321