title: Pregnancy outcomes in women with childhood-onset and adult-onset systemic lupus erythematosus: a comparative study.
abstract: To compare the maternal and fetal outcomes between childhood-onset and adult-onset systemic lupus erythematosus (SLE), we reviewed the medical records of SLE pregnant women treated from January 2005 to August 2013. For comparison, patients were allocated to one of the two groups, those pregnant patients with SLE onset before 18 years of age (childhood-onset) and ≥18 years (adult-onset). The patients were evaluated at least once in each trimester and postpartum. Relevant maternal and fetal outcomes were extracted, such as lupus flare, preeclampsia/eclampsia, rate of liveborns, fetal loss (spontaneous abortion and stillbirth), term delivery, preterm birth, neonatal death, low birth weight, low birth weight at term, and congenital malformations. We studied 186 pregnancies (in 180 women), 58 of them had childhood-onset SLE, and the remaining 128 had adult-onset SLE. The rate of maternal and fetal complications was similar in both groups. Multivariate analysis showed that active SLE before pregnancy, primigravida, renal flare, preeclampsia, lupus flare, anticardiolipin antibodies, and low serum complement were associated with an increased risk of poor maternal and fetal outcomes. The diagnosis of childhood-onset had no impact on maternal-fetal outcome. The maternal and fetal outcome in women with childhood-onset SLE is similar to that reported in women with adult-onset SLE. Pregnancy in women with childhood-onset SLE should not be contraindicated if the disease is well controlled.
authors.affiliation: Rheumatology Department, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico. miansaavsa@gmail.com.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Saavedra
authors.affiliation: Rheumatology Department, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Dafhne
authors.initials: D
authors.lastname: Miranda-Hernández
authors.affiliation: Rheumatology Department, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sánchez
authors.affiliation: Perinatology Department, Hospital de Gineco-Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Sara
authors.initials: S
authors.lastname: Morales
authors.affiliation: Division of Investigation, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Pilar
authors.initials: P
authors.lastname: Cruz-Domínguez
authors.affiliation: Clinical Research Unit, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Medina
authors.affiliation: Direction of Education and Research, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Jara
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult
keywords: Childhood-onset lupus; Maternal–fetal outcome; Pregnancy; Systemic lupus erythematosus