Original Investigations: Pathogenesis and Treatment of Kidney Disease and HypertensionPregnancy in lupus nephritis*,**,*
Section snippets
Patients and methods
Between June 1968 and December 2000, a total of 70 pregnancies occurred in 48 women with lupus nephritis followed up in our renal unit. Thirty-five patients had 1 pregnancy, 7 patients had 2 pregnancies, 4 patients had 3 pregnancies, 1 patient had 4 pregnancies, and 1 patient had 5 pregnancies. Pregnancies were subdivided into two groups. Group A included 13 pregnancies in which lupus nephritis developed for the first time during the pregnancy or early postpartum period. Group B included 51
Group A
At the beginning of pregnancy, mean age of the 13 women was 26.8 ± 3.8 years. In 6 patients, a diagnosis of lupus without renal involvement was made 56.2 ± 55.9 months before pregnancy. In all 6 patients, renal function and urine analysis results were normal. Antiphospholipid antibodies were positive in 6 of 11 women tested.
Group B
This group included 51 pregnancies in 38 patients known to have lupus nephritis before pregnancy (Table 1).
Discussion
In this study, we retrospectively reviewed all pregnancies observed in the last three decades in patients with lupus nephritis. To the best of our knowledge, this is the largest number of pregnant patients with lupus nephritis followed up in a single unit.
Previous reports showed a fetal loss rate ranging from 8% to 40%.1, 2, 3, 4, 5, 6, 7, 8, 9, 10 In this series, overall fetal loss was 36%. However, these data do not reflect the expected outcome today. Fetal loss decreased from 46% in the
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2018, Best Practice and Research: Clinical RheumatologyFetal outcome and recommendations of pregnancies in lupus nephritis in the 21st century. A prospective multicenter study
2016, Journal of AutoimmunityCitation Excerpt :Nonetheless, the rate of fetal loss is still higher than in pregnancies of healthy women. Moreover, lupus can complicate pregnancy with an increased risk of stillbirths, premature deliveries, intrauterine growth retardations and heart problems in the newborn [2,5,9,10]. A systematic review of 37 studies, that included 2751 pregnancy outcomes in 1842 women with lupus nephritis, reported an induced abortion rate of 5.9%.
Maternal outcome in pregnant women with lupus nephritis. A prospective multicenter study
2016, Journal of Autoimmunity
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Supported by the grant Project Glomerulonephritis in memory of Pippo Neglia.
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Address reprint requests to Gabriella Moroni, MD, Divisione di Nefrologia e Dialisi, Ospedale Maggiore IRCCS, Via della Commenda 15-20122, Milano, Italy. E-mail: [email protected]
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