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https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#1
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28256367/impact-of-systemic-lupus-erythematosus-on-maternal-and-fetal-outcomes-following-pregnancy-a-meta-analysis-of-studies-published-between-years-2001-2016
#2
REVIEW
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Feng Huang
BACKGROUND: Previous research has already shown systemic lupus erythematosus (SLE) to have severe consequences on pregnancy outcomes. However, insufficient number of participants, which were mainly limited to one particular region, limited outcomes analyzed and lack of evidence based analysis to support systematic reviews of the literature were the limitations observed. Therefore, by improving these limitations, we aimed to systematically show the impact of SLE on maternal and fetal outcomes following pregnancy...
February 27, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28238314/-obstetrical-aps-is-there-a-place-for-additional-treatment-to-aspirin-heparin-combination
#3
A Mekinian, G Kayem, J Cohen, L Carbillon, N Abisror, L Josselin-Mahr, M Bornes, O Fain
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28205395/pregnancy-outcomes-and-contraceptive-use-in-patients-with-systemic-lupus-erythematosus-rheumatoid-arthritis-and-women-without-a-chronic-illness-a-comparative-study
#4
Priyadarshani Galappatthy, Jayan D D Jayasinghe, Sampath C Paththinige, Rezvi M H Sheriff, Lalith S Wijayaratne
OBJECTIVES: To compare the pregnancy outcomes and contraceptive practices in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and women with no chronic illness (WNCI) in a tertiary care referral center in Colombo, Sri Lanka. METHODS: Patients with SLE satisfying American College of Rheumatology criteria for diagnosis and history of pregnancies were recruited from university lupus clinic, National Hospital of Sri Lanka (NHSL). Age-matched women with history of pregnancy and RA were recruited from the rheumatology clinic, NHSL and WNCI from a surgical clinic...
February 16, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28179384/a-complicated-multisystem-flare-of-systemic-lupus-erythematosus-during-pregnancy
#5
Philip Webster, Catherine Nelson-Piercy, Liz Lightstone
We report a case of systemic lupus erythematosus (SLE) in a young woman who became pregnant amid a severe flare. She continued to have active disease in the face of aggressive treatments complicated by several side effects of immunosuppressive drugs including recurrent sepsis and gestational diabetes. Her fetus was at risk for congenital heart block during the second and third trimesters. Despite an extremely guarded prognosis, she delivered a healthy baby girl. This case highlights the complexities of SLE management during pregnancy...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28162821/safety-of-live-vaccinations-on-immunosuppressive-therapy-in-patients-with-immune-mediated-inflammatory-diseases-solid-organ-transplantation-or-after-bone-marrow-transplantation-a-systematic-review-of-randomized-trials-observational-studies-and-case-reports
#6
REVIEW
Evelina Croce, Christoph Hatz, Emile F Jonker, L G Visser, Veronika K Jaeger, Silja Bühler
BACKGROUND: Live vaccines are generally contraindicated on immunosuppressive therapy due to safety concerns. However, data are limited to corroborate this practice. OBJECTIVES: To estimate the safety of live vaccinations in patients with immune-mediated inflammatory diseases (IMID) or solid organ transplantation (SOT) on immunosuppressive treatment and in patients after bone-marrow transplantation (BMT). DATA SOURCES: A search was conducted in electronic databases (Cochrane, Pubmed, Embase) and additional literature was identified by targeted searches...
March 1, 2017: Vaccine
https://www.readbyqxmd.com/read/28138914/obstetric-and-perinatal-outcome-in-anti-ro-ssa-positive-pregnant-women-a-prospective-cohort-study
#7
Nuria Martínez-Sánchez, Sergio Pérez-Pinto, Ángel Robles-Marhuenda, Francisco Arnalich-Fernández, María Martín Cameán, Edurne Hueso Zalvide, Jose Luis Bartha
Anti-Ro/SS-A is one specific type of antinuclear antibodies. They are in the majority of cases associated with primary Sjögren syndrome (SS) but also in Systemic Lupus Erythematosus (SLE), rheumatoid arthritis (RA), and in healthy people. During pregnancy, they are mainly associated to congenital heart block (CHB) and neonatal lupus (NL). The aim of this study was to compare the rate of maternal and fetal complications between a series of anti-Ro/SS-A positive pregnant women prospectively followed. Forty-two anti-Ro/SSA antibodies positive pregnant women that were referred to our hospital between 2011 and 2015...
January 30, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28130684/clinical-characteristics-and-laboratory-findings-of-252-chinese-patients-with-anti-phospholipid-syndrome-comparison-with-euro-phospholipid-cohort
#8
Hui Shi, Jia-Lin Teng, Yue Sun, Xin-Yao Wu, Qiong-Yi Hu, Hong-Lei Liu, Xiao-Bing Cheng, Yu-Feng Yin, Jun-Na Ye, Pojen P Chen, Cheng-de Yang
This study aims to characterize the Chinese Han patients with anti-phospholipid syndrome (APS) and compare the data with those of the Euro-Phospholipid cohort. We conducted a single center study consisting of 252 patients with definite APS from 2000 to 2015. We analyzed the clinical and laboratory characteristics of our cohort and compared the data with those of the Euro-Phospholipid cohort. Our cohort consisted of 216 females and 36 males, with a mean age at entry into this study of 41 years (range 11-74 years)...
March 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28130617/prolactin-has-a-pathogenic-role-in-systemic-lupus-erythematosus
#9
Luis J Jara, Gabriela Medina, Miguel A Saavedra, Olga Vera-Lastra, Honorio Torres-Aguilar, Carmen Navarro, Monica Vazquez Del Mercado, Luis R Espinoza
Prolactin, a 23-kDa peptide hormone, is produced by the anterior pituitary gland and extrapituitary sites including the immune cells. Prolactin (PRL) participates in innate and adaptive immune response. PRL stimulates the immune cells by binding to receptor (PRL-R). Binding of PRL to its receptor activates the Janus kinase-signal transducer (JAK-STAT). Activation of these cascades results in endpoints such as immunoestimulator and immunosupressor action. Prolactin belongs to the network of immune-neuroendocrine interaction...
January 28, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28121241/systemic-lupus-erythematosus-and-risk-of-preterm-birth-a-systematic-review-and-meta-analysis-of-observational-studies
#10
S Wei, K Lai, Z Yang, K Zeng
We performed a meta-analysis to identify the association between systemic lupus erythematosus (SLE) and preterm birth. In this study, we studied the effects of SLE, SLE disease activity, a history of nephritis and active nephritis on preterm birth. Searches were conducted before 20 May 2016 of PubMed, Embase, Medline and Cochrane Library of literature and article reference lists. Eleven observational case-control studies and thirteen cohort studies met the inclusion criteria. The pooled relative risk (RR) for the risk of preterm birth in SLE patients versus controls was 2...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28120818/pregnancy-and-menopause-in-patients-with-systemic-lupus-erythematosus-and-or-antiphospholipid-syndrome-practical-guide-from-eular
#11
Roberta Vagelli, Chiara Tani, Marta Mosca
Over the last few decades, in reproductive medicine have allowed an improvement in the management and outcome of pregnancy in connective tissue diseases (CTD), such as Systemic progress Lupus Erythematosus and Antiphospholipid Syndrome; however, pregnancy and other related issues represent a crucial moment for patients and their family and some unmet needs are still present. In routine clinical practise, health professionals involved in the care of SLE and/or APS patients need to consider many aspects of the reproductive life of patients, involving not only pregnancy and family planning but also fertility, contraception, cancer surveillance and menopause...
January 25, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28089975/in-vitro-fertilization-in-37-women-with-systemic-lupus-erythematosus-or-antiphospholipid-syndrome-a-series-of-97-procedures
#12
Pauline Orquevaux, Agathe Masseau, Véronique Le Guern, Vanessa Gayet, Danièle Vauthier, Gaelle Guettrot-Imbert, Du Le Thi Huong, Bertrand Wechsler, Nathalie Morel, Patrice Cacoub, Jean-Loup Pennaforte, Jean-Charles Piette, Nathalie Costedoat-Chalumeau
OBJECTIVE: To compile and assess data about complication and success rates for in vitro fertilization (IVF) of women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). To date, such data are sparse. METHODS: This retrospective study described women with SLE and/or APS who have had at least 1 IVF cycle. RESULTS: Thirty-seven women with SLE (n = 23, including 8 with antiphospholipid antibodies), SLE with APS (n = 4), or primary APS (n = 10) underwent 97 IVF procedures...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28013193/medication-use-among-pregnant-women-with-systemic-lupus-erythematosus-and-general-population-comparators
#13
Kristin Palmsten, Julia F Simard, Christina D Chambers, Elizabeth V Arkema
OBJECTIVE: The aim was to characterize SLE medication trends before, during and after pregnancy and to compare other commonly used medications during SLE pregnancies with non-SLE pregnancies. METHODS: Women with pregnancies ending in live birth or stillbirth were identified from the Swedish Medical Birth Register (2006-12). National registers were used to identify women with prevalent SLE during pregnancy and a sample without SLE and to identify prescription medications dispensed from 3 months pre-pregnancy until 6 months postpartum...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/27998874/-analysis-of-pregnancy-outcomes-in-66-patients-with-systemic-lupus-erythematosus
#14
Xiu-Zhen Song, Jia-Mian Chen, Qiu-Gen Zhou
OBJECTIVE: To analyze the outcomes of pregnancies in women with systemic lupus erythematosus (SLE) and the risk factors affecting the outcomes. METHODS: The data of SLE patients with pregnancy admitted from October, 2006 and September, 2015 were analyzed for assessing the maternal and fetal outcomes and complications. Their risk factors affecting the outcomes of the pregnancies were analyzed. RESULTS: The 66 SLE patients (69 pregnancies) had a mean age at SLE diagnosis of 22...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27992461/long-term-outcomes-of-systemic-lupus-erythematous-patients-after-pregnancy-a-nationwide-population-based-cohort-study
#15
Ting-Fang Chiu, Ya-Wen Chuang, Cheng-Li Lin, Tung-Min Yu, Mu-Chi Chung, Chi-Yuan Li, Chi-Jung Chung, Wen-Chao Ho
BACKGROUND: Data on long-term maternal outcomes in patients with systemic lupus erythematosus (SLE) are lacking. The study aimed to explore the relationships among SLE, pregnancy, outcomes of end-stage renal disease (ESRD), and overall mortality. METHODS: We established a retrospective cohort study consisting of four cohorts: pregnant (case cohort) and nonpregnant SLE patients, as well as pregnant and nonpregnant non-SLE patients. One case cohort and three comparison cohorts were matched by age at first pregnancy and index date of pregnancy by using the Taiwan National Health Insurance Research Dataset...
2016: PloS One
https://www.readbyqxmd.com/read/27943386/early-onset-preeclampsia-in-lupus-pregnancy
#16
Julia F Simard, Elizabeth V Arkema, Cathina Nguyen, Elisabet Svenungsson, Anna-Karin Wikström, Kristin Palmsten, Jane E Salmon
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that occurs during childbearing years and has been associated with preeclampsia. However, little is known about preeclampsia of early onset, which is associated with severe adverse maternal and perinatal outcomes. METHODS: Using national population-based Swedish registers we identified women with SLE (≥2 visits with corresponding ICD codes) and a sample without SLE who gave birth to singleton infants 2001-12...
January 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/27919382/a-clinical-decision-support-system-for-prediction-of-pregnancy-outcome-in-pregnant-women-with-systemic-lupus-erythematosus
#17
Khadijeh Paydar, Sharareh R Niakan Kalhori, Mahmoud Akbarian, Abbas Sheikhtaheri
OBJECTIVE: Pregnancy among systemic lupus erythematosus (SLE)-affected women is highly associated with poor obstetric outcomes. Predicting the risk of foetal outcome is essential for maximizing the success of pregnancy. This study aimed to develop a clinical decision support system (CDSS) to predict pregnancy outcomes among SLE-affected pregnant women. METHODS: We performed a retrospective analysis of 149 pregnant women with SLE, who were followed at Shariati Hospital (104 pregnancies) and a specialized clinic (45 pregnancies) from 1982 to 2014...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27875058/antenatal-stressful-life-events-and-postpartum-depressive-symptoms-in-the-united-states-the-role-of-women-s-socioeconomic-status-indices-at-the-state-level
#18
Soumyadeep Mukherjee, Stefany Coxe, Kristopher Fennie, Purnima Madhivanan, Mary Jo Trepka
BACKGROUND: Approximately 10%-20% of women suffer from postpartum depression (PPD), important predictors of which are antenatal stressful life event (SLE) experiences. The association between women's state-level socioeconomic status (SES) and PPD has not been explored. This study aimed to examine whether the association between antenatal SLE and PPD symptoms was moderated by women's state-level SES. METHODS: Data from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS) were used...
March 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/27865435/the-pulse-mass-index-as-a-predictor-of-cardiovascular-events-in-women-with-systemic-lupus-erythematosus
#19
Elsy Aidé García-Villegas, Horacio Márquez-González, Luis Felipe Flores-Suárez, Antonio Rafael Villa-Romero
BACKGROUND: Patients with systemic lupus erythematosus (SLE) have 3times the risk of death compared to the rest of the population, with cardiovascular events (CVD) being one of the main causes. Índices such as waist-height (W-Ht I), waist-hip (W-Hp I) and pulse-mass (PMI) predict CVD, though the behaviour is unknown in patients with SLE. The aim of this study was to determine the prognostic value of PMI in the development of CVD in premenopausal women with SLE. METHODOLOGY: Cohort study...
January 20, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/27852374/-clinical-features-and-adverse-pregnancy-outcomes-of-new-onset-systemic-lupus-erythematosus-during-pregnancy
#20
Z P Zhan, Y Yang, Y F Zhan, D Y Chen, L Q Liang, X Y Yang
Objective: To investigate the clinical characteristics and adverse pregnancy outcomes in pregnant women with new onset systemic lupus erythematosus (SLE) during pregnancy. Methods: The clinical data of 263 pregnancies with SLE in the First Affiliated Hospital of Zhongshan University from 2001 to 2015 were collected and analyzed retrospectively. Results: Of all the 263 pregnancies, 188 were diagnosed before pregnancy and 75 were newly diagnosed during pregnancy. Among the 75 new onset SLE, 27, 31, 14 and 3 cases were diagnosed during first trimester, second trimester, third trimester and puerperium, respectively...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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