Clinical features and outcome of pregnancy with SLE-associated thrombocytopenia.
OBJECTIVE
To analyze the course of maternal diseases and compare pregnancy outcomes in patients with systemic lupus erythematosus (SLE)-associated thrombocytopenia to patients without.


METHODS
Medical charts of 77 pregnancies in 73 SLE patients were systematically reviewed. Patients were divided into two groups according to the presence or absence of thrombocytopenia. Patients who are new onset SLE during pregnancy were also been studied.


RESULTS
Thrombocytopenia was found in 18 (23.3%) of the pregnancies. SLE patients with thrombocytopenia during pregnancy had higher percentage of disease flaring (11/18 versus 14/59, p = 0.003) and SLE-Pregnancy Disease Activity Index (7.89 ± 6.192 versus 2.41 ± 3.3.89, p = 0.001) compared to patients without. Also, patients with thrombocytopenia had a higher percentage of pulmonary, cardiac and multiple organ system involvement. There was a statistically significant difference in preeclampsia and early onset hypertensive disorder induced before 34 weeks as well as the rate of live birth less than 34 weeks (33.3% versus 6.8%, p = 0.003 & 38.9% versus 13.6%, p = 0.018 & 16.7% versus 1.7%, p = 0.038). Patients with thrombocytopenia suffered from higher rate of pregnancy loss (22.2% versus 3.4%, p = 0.024) and neonatal death (33.3% versus 1.7%, p = 0.000). In our study there were 17 patients with new-onset of SLE during pregnancy. The hematological system manifestation occurred in all of them and there was a significant increase in the incidence of thrombocytopenia (n = 12, 70.6%).


CONCLUSIONS
Thrombocytopenia in SLE during pregnancy indicates higher disease activity, severe organ damage, early onset preeclampsia and higher pregnancy loss.
a Department Obstetrics and Gynecology , Peking University People's Hospital , Beijing , China and.
Xue
X
Xu
a Department Obstetrics and Gynecology , Peking University People's Hospital , Beijing , China and.
Mei-Ying
MY
Liang
a Department Obstetrics and Gynecology , Peking University People's Hospital , Beijing , China and.
Jian-Liu
JL
Wang
b Department of Rheumatology , Peking University People's Hospital , Beijing , China.
Shi
S
Chen
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
Pregnancy; SLE; thrombocytopenia