Pregnancy outcome in juvenile systemic lupus erythematosus: A Brazilian multicenter cohort study

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Autor(es): dc.contributorUniversidade de São Paulo (USP)-
Autor(es): dc.contributorFederal University of Rio de Janeiro-
Autor(es): dc.contributorSanta Casa of São Paulo-
Autor(es): dc.contributorState University of Rio de Janeiro-
Autor(es): dc.contributorUniversidade Estadual de Campinas (UNICAMP)-
Autor(es): dc.contributorSanta Casa of Belo Horizonte-
Autor(es): dc.contributorHospital São Rafael-Bahia-
Autor(es): dc.creatorSilva, Clovis A. A.-
Autor(es): dc.creatorHilario, Maria O.-
Autor(es): dc.creatorFebronio, Marilia V.-
Autor(es): dc.creatorOliveira, Sheila K.-
Autor(es): dc.creatorAlmeida, Rozana G.-
Autor(es): dc.creatorFonseca, Adriana R.-
Autor(es): dc.creatorYamashita, Edson M.-
Autor(es): dc.creatorRonchezel, Marcos V.-
Autor(es): dc.creatorCampos, Luciene L.-
Autor(es): dc.creatorAppenzeller, Simone-
Autor(es): dc.creatorQuintero, Maria V.-
Autor(es): dc.creatorSantos, Ana B.-
Autor(es): dc.creatorMedeiros, Ana C.-
Autor(es): dc.creatorCarvalho, Luciana M.-
Autor(es): dc.creatorRobazzi, Teresa C.-
Autor(es): dc.creatorCardin, Silvana P.-
Autor(es): dc.creatorBonfa, Eloisa-
Data de aceite: dc.date.accessioned2022-08-04T22:01:48Z-
Data de disponibilização: dc.date.available2022-08-04T22:01:48Z-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2008-07-01-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/219463-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/219463-
Descrição: dc.descriptionObjective. To determine pregnancy outcome and fetal loss risk factors in patients with juvenile systemic lupus erythematosus (JSLE). Methods. A total of 315 female patients with JSLE followed in 12 Brazilian pediatric rheumatology centers were consecutively selected. Menarche was observed in 298 (94.6%) patients. Patients' medical records were reviewed for pregnancy outcomes and demographic, clinical, and therapeutic data. Results. A total of 24 unplanned pregnancies occurred in 298 (8%) patients. The outcomes were 5 (21%) early fetal losses (prior to 16 wks gestation), 18 (75%) live births, and 1 (4%) death due to preeclampsia and premature birth. The frequencies of active diffuse proliferative glomerulonephritis, proteinuria ≥ 0.5 g/day, and arterial hypertension at the beginning of pregnancy were higher in pregnancies resulting in fetal losses than in live births [60% vs 5% (p = 0.02), 60% vs 5% (p = 0.02). 60% vs 5% (p = 0.02), respectively]. JSLE pregnancies with fetal losses had a significantly higher mean SLE Disease Activity Index 2000 (SLEDAI-2K) at the start of pregnancy compared with those with live births (9.40 ± 7.47 vs 3.94 ± 6.00; p = 0.049). Four pregnancies were inadvertently exposed to intravenous cyclophosphamide therapy for renal involvement despite contraceptive prescriptions, resulting in fetal loss in 3 (p = 0.02). In multivariate analysis only intravenous cyclophosphamide use at start of pregnancy (OR 25.50, 95% CI 1.72-377.93, p = 0.019) remained as an independent risk factor for fetal loss. Conclusion. We identified immunosuppressive therapy as the major contributing factor for fetal loss in JSLE, reinforcing the importance of contraception.-
Descrição: dc.descriptionPaediatric Rheumatology Unit University of São Paulo-
Descrição: dc.descriptionPaediatric Rheumatology Unit Federal University of São Paulo-
Descrição: dc.descriptionPaediatric Rheumatology Unit Federal University of Rio de Janeiro-
Descrição: dc.descriptionPaediatric Rheumatology Unit Santa Casa of São Paulo-
Descrição: dc.descriptionPaediatric Rheumatology Unit State University of Rio de Janeiro-
Descrição: dc.descriptionPaediatric Rheumatology Unit State University of Campinas-
Descrição: dc.descriptionPaediatric Rheumatology Unit Santa Casa of Belo Horizonte-
Descrição: dc.descriptionDivision of Rheumatology Federal University of Rio de Janeiro-
Descrição: dc.descriptionDivision of Rheumatology University of São Paulo-
Descrição: dc.descriptionUniversity of São Paulo-Ribeirão Preto-
Descrição: dc.descriptionHospital São Rafael-Bahia-
Descrição: dc.descriptionState University of São Paulo-Botucatu-
Formato: dc.format1414-1418-
Idioma: dc.languageen-
Relação: dc.relationJournal of Rheumatology-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectAdolescent-
Palavras-chave: dc.subjectCyclophosphamide-
Palavras-chave: dc.subjectFetal loss-
Palavras-chave: dc.subjectOutcome-
Palavras-chave: dc.subjectPregnancy-
Palavras-chave: dc.subjectSystemic lupus erythematosus-
Título: dc.titlePregnancy outcome in juvenile systemic lupus erythematosus: A Brazilian multicenter cohort study-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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