Purpose The consequences of maternal systemic lupus erythematosus (SLE) on neonatal
June 17, 2017
Purpose The consequences of maternal systemic lupus erythematosus (SLE) on neonatal prognosis were examined by comparing clinical features of full-term babies born to lupus mothers and age- and parity-matched controls. observed in Apgar score, birth weight, gestational age, SGA frequency, and platelet count between lupus subgroups formed based on anti-dsDNA antibody levels and antiphospholipid antibody status. Conclusion The association of maternal ANAs, antiphospholipid antibodies, and drug history with neonatal prognosis could not be elucidated. However, even in uncomplicated pregnancies, maternal lupus Rabbit polyclonal to AnnexinA11. is disadvantageous for gestational age, birth weight, and SGA frequency. < 0.05). The frequency of SGA was 7 cases (25%) in the lupus group and 3 (4.5%) in the control group, and a significant difference was observed between the 2 groups (< 0.05). Thus, compared with the control group, the lupus group had relatively lower birth weight and gestational age and higher SGA frequency (Table 2). There were no significant differences in gender ratio, 1-min and 5-min Apgar scores < 7, and days of hospital stay between BAY 73-4506 the 2 groups. Table 2 Comparison of Perinatal Outcomes between Lupus and Control Groups Antinuclear antibody and platelet count of neonates ANA testing was performed in 17 neonates in the lupus group; 10 neonates were BAY 73-4506 tested positive for anti-dsDNA antibodies at birth and converted to negative at 6 – 12 month after birth. Anti-Ro/SS-A and anti-La/SS-B antibodies were detected in 5 and 3 neonates, respectively (Table 3). Three cases were tested positive for Ro/SS-A and La/SS-B autoantibodies in concomitance. Table 3 Laboratory Findings of Lupus Group None of the neonates showed congenital heart block on electrocardiogram at birth and during the monitoring period or developed neonatal lupus due to ANA transmission from your mother. Among the pregnant women in the lupus group, thrombocytopenia (platelet count of mother < 100,000/mm3) was observed in 7 women (25.9%) and 2 of their neonates (platelet count of neonate < 150,000/mm3). In all, 5 neonates showed thrombocytopenia (platelet count of neonate < 150,000/mm3), and they recovered within 14 days after birth without any special treatment. Perinatal end result according to lupus activity The 2 2 lupus subgroups based on the maternal anti-dsDNA antibody titers showed no significant differences in 1-minute and 5-minute Apgar scores < 7, birth weight, gestational age, SGA frequency, and platelet count (Table 4). The differences in the clinical manifestations including a history of thrombosis, late-term pregnancy loss, or 3 prior first-trimester miscarriages observed between the 2 subgroups was not significant. Table 4 Comparison of Perinatal Outcomes between High- and Low-risk Subgroups (by anti-dsDNA antibody titer) in Lupus Group Similarly, the 2 2 lupus subgroups, based on antiphospholipid autoantibody status, showed no significant differences in BAY 73-4506 1-minute and 5-minute Apgar scores of the neonates, birth weight, gestational age, SGA frequency, and platelet count (Table 5). Meanwhile, patients with or without antiphospholipidic antibodies (aPL) were provided with comparable treatment. In the lupus group, medication history prior to pregnancy included systemic BAY 73-4506 steroids in 25 patients, hydroxychloroquine in 11, azathioprine in 2, methotrexate in 1 (the neonate did not exhibit any fetal abnormality), and aspirin in 10. In 6 patients with aPL, medication history prior to pregnancy included systemic steroids in 6 patients, hydroxychloroquine in 3, azathioprine in 2, and aspirin in 4. Furthermore, medication history of patients with aPL during pregnancy included systemic steroids in 6 patients and aspirin in 4. Table 5 Comparison of Perinatal Outcomes between aPL-positive and -unfavorable Subgroups in Lupus Group Conversation Lupus mothers have a high risk of going through spontaneous abortion, stillbirth, prematurity, and IUGR.1-4 In 1993, Petri et al.5 examined 481 neonates born to 203 lupus.