Ann Intern Med:系统性红斑狼疮患者孕产妇和胎儿结局趋势

2019-07-14 xing.T MedSci原创

在这项评估SLE和非SLE妊娠超过18年的大型研究中,院内孕产妇死亡率和总体结局显著改善,尤其是SLE女性。然而,仍需要改善,因为SLE患者的妊娠风险仍然很高。

尽管系统性红斑狼疮(SLE)患者妊娠对孕妇和胎儿都具有高风险,但结局可能正在改善。近日,内科学权威杂志Annals of Internal Medicine上发表了一篇研究文章,该研究旨在评估SLE患者孕产妇和胎儿并发症的全国性趋势和差异。

该研究为1988年至2015年在美国进行的回顾性队列研究,受试者为在国家住院病例(NIS)数据库中有住院治疗记录的有和没有SLE成年孕妇。结局指标包括院内孕产妇死亡率、胎儿死亡率、先兆子痫或子痫、剖腹产、未分娩相关入院和住院时间。为了评估SLE患者与无SLE患者的结局随时间变化的趋势,使用年度和SLE之间的相互作用的Logistic或线性回归(是或否)进行分析。研究人员获得了包含抽样和分层权重的全国人口估计数。

研究人员估计有93820名SLE孕妇和78045054名无SLE患者于1998年至2015年在美国住院治疗。在这18年中,结局有所改善。无症状患者和非SLE患者的院内孕产妇死亡率(每10万人入院率)下降(1998年至2000年为442 vs. 13,2013至2015年为<50 vs. 10),尽管女性SLE患者死亡率下降 (趋势差异,P<0.002)。在所有与妊娠有关的以及与分娩相关的入院中,SLE患者的百分比显著增加。

在这项评估SLE和非SLE妊娠超过18年的大型研究中,院内孕产妇死亡率和总体结局显著改善,尤其是SLE女性。然而,仍需要改善,因为SLE患者的妊娠风险仍然很高。 

原始出处:

Bella Mehta, MBBS,et al.Trends in Maternal and Fetal Outcomes Among Pregnant Women With Systemic Lupus Erythematosus in the United States: A Cross-sectional Analysis.AIM.2019.https://annals.org/aim/article-abstract/2737824/trends-maternal-fetal-outcomes-among-pregnant-women-systemic-lupus-erythematosus

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