NGHIÊN CỨU KẾT CỤC THAI KỲ Ở THAI PHỤ MẮC BỆNH LUPUS BAN ĐỎ HỆ THỐNG TẠI BỆNH VIỆN TỪ DŨ

Abstract

Background: Pregnant women with Systemic Lupus Erythematosus (SLE) represent a high-risk pregnancy, with increased dangerous complications including preeclampsia-eclampsia, preterm birth, unplanned cesarean delivery, intrauterine growth restriction, miscarriage, intrauterine fetal death, neonatal lupus syndrome, and congenital heart disease. Objectives: To describe the clinical characteristics of pregnant women with SLE admitted for delivery at Từ Dũ Hospital and to analyze the maternal and fetal outcomes in these patients. Methods: A retrospective case series report on pregnant women with SLE admitted for delivery at Từ Dũ Hospital from December 2018 to December 2023. Results: Of the pregnant women, 94.2% were diagnosed and treated for SLE before pregnancy, while 5.8% had an onset during pregnancy. During pregnancy, adverse maternal outcomes occurred in 82.1% of cases, including lupus nephritis and renal complications (38.5%), anemia (42.3%), thrombocytopenia (15.4%), preeclampsia (18.6%), HELLP syndrome (2.6%), postpartum hemorrhage (6.4%), blood transfusion (12.2%), and postpartum infections (11.5%). Adverse neonatal outcomes occurred in 72.4% of cases, including stillbirth (5.8%), miscarriage (5.1%), preterm birth (44.8%), NICU admission (35.3%), and perinatal death (16%, including stillbirth, congenital anomalies, and neonatal death). Additionally, two neonates had neonatal lupus syndrome. These rates were statistically significantly higher compared to the general population. Conclusion: Factors related to adverse maternal outcomes include gestational age at delivery < 34 weeks (OR = 9.42; 95% CI: 2.03 - 43.71) and decreased C3 levels < 90 (OR = 2.64; 95% CI: 1.09 - 6.41). The factor related to adverse neonatal outcomes is maternal Anti-dsDNA ≥ 40 (OR = 3.48; 95% CI: 1.2 - 10.1). Therefore, monitoring strategies are needed for pregnant women with SLE who exhibit these factors.