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lupus and pregnancy

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https://www.readbyqxmd.com/read/28540416/breastfeeding-initiation-duration-and-reasons-for-weaning-in-patients-with-systemic-lupus-erythematosus
#1
Magdalena Acevedo, Julia Pretini, Marina Micelli, Gabriel Sequeira, Eduardo Kerzberg
To assess breastfeeding in patients with systemic lupus erythematosus (SLE), a cross-sectional study of patients with SLE compared to a non-SLE sample was performed. Patients who had pregnancies subsequent to their diagnosis of SLE and who were followed up in the hospital were interviewed. The group of non-SLE mothers consisted of patients who had no known rheumatic disease at the time of their pregnancy, and who were approached at the hospital paediatrics service waiting room. Thirty-six pregnancies in 31 patients with SLE and the same number of non-SLE mothers were studied...
May 24, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28532221/antiphospholipid-antibodies-are-associated-with-positive-screening-for-common-mental-disorders-in-women-with-previous-pregnancy-loss-the-noha-psy-observational-study
#2
Jean-Christophe Gris, Fabienne Cyprien, Sylvie Bouvier, Eva Cochery-Nouvellon, Géraldine Lavigne-Lissalde, Erick Mercier, Jean-Pierre Balducchi
OBJECTIVE: Case reports describe neuropsychiatric manifestations associated with antiphospholipid antibodies (aPlAbs). In patients sharing the same symptoms fulfilling the antiphospholipid syndrome (APS) clinical criteria, the prevalence of common mental disorders has however never been studied. METHOD: We observed women with three consecutive abortions before the 10(th) week of gestation or one fetal loss at or beyond the 10(th) week. We compared the prevalence of common psychiatric disorders detected through screening using the Mini International Neuropsychiatric Interview, 10 years after inclusion, in women with APS (n = 506), women negative for aPlAbs but carrying the F5rs6025 or F2rs1799963 thrombogenic polymorphism (n = 269), and women with negative thrombophilia screening results as controls (n = 764)...
May 22, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28532196/fetal-and-neonatal-involvement-in-maternal-rheumatologic-disease
#3
Shigeo Iijima
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjögren syndrome (pSS) tends to result in preterm delivery and low birthweight infants...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28522651/pregnancy-and-glomerular-disease-a-systematic-review-of-the-literature-with-management-guidelines
#4
Kimberly Blom, Ayodele Odutayo, Kate Bramham, Michelle A Hladunewich
During pregnancy, CKD increases both maternal and fetal risk. Adverse maternal outcomes include progression of underlying renal dysfunction, worsening of urine protein, and hypertension, whereas adverse fetal outcomes include fetal loss, intrauterine growth restriction, and preterm delivery. As such, pregnancy in young women with CKD is anxiety provoking for both the patient and the clinician providing care, and because the heterogeneous group of glomerular diseases often affects young women, this is an area of heightened concern...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28515823/lupus-negative-libman-sacks-endocarditis-complicated-by-catastrophic-antiphospholipid-syndrome
#5
Ghulam Murtaza, Joy Iskandar, Tara Humphrey, Sujeen Adhikari, Aneesh Kuruvilla
Libman-Sacks endocarditis is characterized by sterile and verrucous lesions that predominantly affect the aortic and mitral valves. In most cases, patients do not have significant valvular dysfunction. However, patients with significant valvular dysfunction may present with serious complications such as cardiac failure, arrhythmias, and thromboembolic events. Recently, association of Libman-Sacks endocarditis with antiphospholipid antibody syndrome (APS) has been made. APS is most commonly defined by venous and arterial thrombosis, recurrent pregnancy loss, and thrombocytopenia...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28508528/competing-risks-model-in-screening-for-preeclampsia-in-twin-pregnancies-by-maternal-characteristics-and-medical-history
#6
Carla Francisco, David Wright, Zsófia Benkő, Argyro Syngelaki, Kypros H Nicolaides
OBJECTIVE: A survival-time regression model for the gestational age at delivery with preeclampsia (PE) in singleton pregnancies using maternal demographic characteristics and medical history was previously reported. The objective of this paper is to extend this model for dichorionic (DC) and monochorionic (MC) twin pregnancies. METHODS: The study population included 1,789 DC and 430 MC twin pregnancies and 93,297 singleton pregnancies. A survival-time model for the gestational age at delivery with PE was developed from variables of maternal characteristics and history...
May 15, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28497000/what-is-the-teratogenic-risk-of-mycophenolate
#7
Ranjit I Kylat
Mycophenolate is often used in the management of systemic lupus erythematosus. It has often been associated with significant fetal embryopathy, including fetal loss and multiple anomalies. The Food and Drug Administration has directed that women should be counseled regarding this prior to initiating treatment with this drug. Isolated total anomalous pulmonary venous return (TAPVR) is a rare association seen with its use in pregnancy.
June 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/28492052/dermatologic-conditions-in-patients-of-color-who-are-pregnant
#8
REVIEW
C Jeon, O Agbai, D Butler, J Murase
Certain dermatoses that present during pregnancy have a predilection for populations with skin of color (SOC). Additionally, certain systemic diseases such as systemic lupus erythematosus tend to be more aggressive during pregnancy and confer worse prognoses in women with SOC. The purpose of this review is to highlight the unique implications of selected diseases during pregnancy as it relates to SOC. Dermatologists should be vigilant for the unique clinical variations of dermatological conditions in patients of color who are pregnant to ensure correct diagnoses and optimize treatment outcomes...
March 2017: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/28480786/ultraviolet-a1-irradiation-therapy-for-systemic-lupus-erythematosus
#9
H McGrath
Systemic lupus erythematosus (lupus, SLE) is a chronic autoimmune disease characterized by the production of autoantibodies, which bind to antigens and are deposited within tissues to fix complement, resulting in widespread systemic inflammation. The studies presented herein are consistent with hyperpolarized, adenosine triphosphate (ATP)-deficient mitochondria being central to the disease process. These hyperpolarized mitochondria resist the depolarization required for activation-induced apoptosis. The mitochondrial ATP deficits add to this resistance to apoptosis and also reduce the macrophage energy that is needed to clear apoptotic bodies...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28480528/socioeconomic-status-contributes-to-racial-ethnic-disparities-in-adverse-pregnancy-outcomes-among-women-with-systemic-lupus-erythematosus
#10
Elianna T Kaplowitz, Sancia Ferguson, Marta Guerra, Carl A Laskin, Jill P Buyon, Michelle Petri, Michael D Lockshin, Lisa R Sammaritano, D Ware Branch, Joan T Merrill, Patricia Katz, Jane E Salmon
OBJECTIVE: We examined rates of adverse pregnancy outcomes (APOs) by race/ethnicity among women with systemic lupus erythematosus (SLE), with and without anti-phospholipid antibodies (aPL), and whether socioeconomic status (SES) accounted for differences. METHODS: Data were from PROMISSE, a multi-center study that enrolled 346 patients with SLE and 62 patients with SLE and aPL (50% White, 20% Black, 17% Hispanic, 12% Asian/Pacific Islander). Measures of SES were educational attainment, median community income, and community education...
May 8, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28471597/women-s-issues-in-antiphospholipid-syndrome
#11
Emmanouil Papadakis, Anastasia Banti, Anna Kioumi
Antiphospholipid syndrome (APS) is an autoimmune systemic disease characterized by vascular thrombosis (arterial or venous) and/or pregnancy complications associated with the occurrence of autoantibodies, specifically lupus anticoagulant, anticardiolipin antibodies, and/or anti-β2 glycoprotein-I antibodies confirmed at least twice over a 12 week period according to the 2006 Sydney criteria. Antiphospholipid antibodies are encountered  in the general population with a reported prevalence of 1% to 5%  However, APS is far more infrequent with a prevalence of 40-50/100,000 persons and an incidence of about 5 new patients/100,000 persons...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28470478/does-aps-impact-women-s-fertility
#12
REVIEW
Cecilia Beatrice Chighizola, Maria Gabriella Raimondo, Pier Luigi Meroni
PURPOSE OF REVIEW: This review focuses on the relationship between anti-phospholipid antibodies (aPL) and female infertility by addressing three key questions: (i) how can aPL induce women's infertility?; (ii) are aPL more prevalent among infertile than fertile women?; (iii) do aPL-positive women display reduced fertility? RECENT FINDINGS: According to experimental data, aPL impair female fertility interfering with endometrial decidualization thus with implantation...
June 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28467291/clinical-associations-of-proinflammatory-cytokines-oxidative-biomarkers-and-vitamin-d-levels-in-systemic-lupus-erythematosus
#13
R Willis, M Smikle, K DeCeulaer, Z Romay-Penabad, E Papalardo, P Jajoria, B Harper, V Murthy, M Petri, E B Gonzalez
Background The abnormal biological activity of cytokines plays an important role in the pathophysiology of both systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Several studies have highlighted the association of vitamin D and certain pro-inflammatory cytokines with disease activity in SLE. However, there are limited data on the association of vitamin D and antiphospholipid antibodies (aPL) with various proinflammatory biomarkers in these patients and their relative impact on clinical outcomes...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28463907/placenta-previa-increta-in-an-unscarred-uterus-with-marked-thinning-of-myometrium-in-the-entire-uterus-in-a-patient-with-systemic-lupus-erythematosus
#14
Namita Mittal, Maylene Pineda, Boon Lim, Elizabeth Carey
A 36-yr-old woman, G5P2, who had a background history of systemic lupus erythematosus (SLE) was found to have placenta previa and placenta accreta on second trimester ultrasound scan. She had previous 3 spontaneous miscarriages but there was no history of gynecologic interventions. Apart from SLE, there was no other explanation for her recurrent miscarriage. The patient had ongoing thrombocytopenia in this pregnancy. The patient was taken for elective lower uterine segment cesarean section at 36 wk+5 d gestation...
April 29, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28441446/fetal-outcomes-and-associated-factors-of-adverse-outcomes-of-pregnancy-in-southern-chinese-women-with-systemic-lupus-erythematosus
#15
Zhongping Zhan, Ying Yang, Yanfeng Zhan, Dongying Chen, Liuqin Liang, Xiuyan Yang
This study aims to investigate the fetal outcomes and associated factors of adverse pregnancy outcomes (APOs) in pregnant women with systemic lupus erythematosus (SLE). Clinical data from 251 SLE patients with 263 pregnancies from 2001 to 2015 were analyzed retrospectively. APOs occurred in 70.0% of pregnancies, in which pregnancy loss occurred in 28.5%; preterm delivery occurred in 21.3%; intrauterine growth retardation occurred in 12.2%; and fetal distress occurred in 8.0%. Over time, the rate of APOs decreased from 82...
2017: PloS One
https://www.readbyqxmd.com/read/28424481/the-first-genome-wide-association-study-identifying-new-susceptibility-loci-for-obstetric-antiphospholipid-syndrome
#16
Mayumi Sugiura-Ogasawara, Yosuke Omae, Minae Kawashima, Licht Toyo-Oka, Seik-Soon Khor, Hiromi Sawai, Tetsuya Horita, Tatsuya Atsumi, Atsuko Murashima, Daisuke Fujita, Tomio Fujita, Shinji Morimoto, Eriko Morishita, Shinji Katsuragi, Tamao Kitaori, Kinue Katano, Yasuhiko Ozaki, Katsushi Tokunaga
Antiphospholipid syndrome (APS) is the most important treatable cause of recurrent pregnancy loss. The live birth rate is limited to only 70-80% in patients with APS undergoing established anticoagulant therapy. Lupus anticoagulant (LA), but not anticardiolipin antibody (aCL), was found to predict adverse pregnancy outcome. Recent genome-wide association studies (GWAS) of APS focusing on aCL have shown that several molecules may be involved. This is the first GWAS for obstetric APS focusing on LA. A GWAS was performed to compare 115 Japanese patients with obstetric APS, diagnosed according to criteria of the International Congress on APS, and 419 healthy individuals...
April 20, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28422424/pregnancy-outcomes-in-women-with-different-doses-of-corticosteroid-supplementation-during-labor-and-delivery
#17
Takao Owa, Kazuya Mimura, Aiko Kakigano, Shinya Matsuzaki, Keiichi Kumasawa, Masayuki Endo, Takuji Tomimatsu, Tadashi Kimura
AIM: The aim of this study was to report the pregnancy outcomes of women who received different doses of corticosteroid supplementation during labor and delivery. METHODS: We conducted a retrospective review of 102 pregnant women who received oral corticosteroid therapy, delivered at Osaka University Hospital, and were administered intravenous corticosteroid supplementation during labor and delivery. From January 2008 to May 2012, 47 women were administered a high dose of corticosteroids (HD group)...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28405983/reproductive-health-in-systemic-lupus-erythematosus-an-experience-from-government-hospital-in-western-india
#18
Rushabh Kothari, Amruta Digole, Sandip Kamat, Y S Nandanwar, Yojana Gokhale
AIM: Systemic lupus erythematosus is an autoimmune disease which affects the reproductive health of women pertaining to disease or its treatment. However, Indian data is limited. Objective is to study menstrual disturbances and maternal and fetal outcome during pregnancy in SLE patients. METHODS: This retrospective and prospective observational study was conducted for a period of 18 months from March 2012 to September 2013 in a tertiary care hospital in Mumbai. The study included serial recruitment of SLE patients fulfilling inclusion criteria...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28401195/live-birth-pregnancy-outcome-after-first-in-vitro-fertilization-treatment-in-a-patient-with-systemic-lupus-erythematosus-and-isolated-high-positive-iga-anti-%C3%AE-2glycoprotein-i-antibodies-a-case-report
#19
Hristina Andreeva, Marit Seip, Stanislava Koycheva
IgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28400421/kidney-outcomes-and-risk-factors-for-nephritis-flare-de-novo-in-a-multiethnic-cohort-of-pregnant-patients-with-lupus
#20
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
BACKGROUND AND OBJECTIVES: Kidney disease is a critical concern in counseling patients with lupus considering pregnancy. This study sought to assess the risk of renal flares during pregnancy in women with previous lupus nephritis in partial or complete remission, particularly in those with antidouble-stranded DNA antibodies and low complement levels, and the risk of new-onset nephritis in patients with stable/mildly active SLE. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We assessed active nephritis (renal flares and de novo kidney disease) and associated predictors during pregnancy in patients with lupus with urine protein ≤1000 mg and serum creatinine <1...
April 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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