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Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome

A prospectively study of pregnant women with systemic lupus erythematosus (SLE), antiphospholipid syndrome, or non-criteria obstetric antiphospholipid syndrome was conducted to describe the characteristics of women followed in a referral unit and to derive a predictive tool for adverse pregnancy out...

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Autores principales: Baños, Núria, Castellanos, Aleida Susana, Barilaro, Giuseppe, Figueras, Francesc, Lledó, Gema María, Santana, Marta, Espinosa, Gerard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9696942/
https://www.ncbi.nlm.nih.gov/pubmed/36431299
http://dx.doi.org/10.3390/jcm11226822
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author Baños, Núria
Castellanos, Aleida Susana
Barilaro, Giuseppe
Figueras, Francesc
Lledó, Gema María
Santana, Marta
Espinosa, Gerard
author_facet Baños, Núria
Castellanos, Aleida Susana
Barilaro, Giuseppe
Figueras, Francesc
Lledó, Gema María
Santana, Marta
Espinosa, Gerard
author_sort Baños, Núria
collection PubMed
description A prospectively study of pregnant women with systemic lupus erythematosus (SLE), antiphospholipid syndrome, or non-criteria obstetric antiphospholipid syndrome was conducted to describe the characteristics of women followed in a referral unit and to derive a predictive tool for adverse pregnancy outcome (APO). Demographic characteristics, treatments, SLE activity, and flares were recorded. Laboratory data included a complete blood cell count, protein-to-creatinine urinary ratio (Pr/Cr ratio), complement, anti dsDNA, anti-SSA/Ro, anti-SSB/La, and antiphospholipid antibodies status. A stepwise regression was used to identify baseline characteristics available before pregnancy and during the 1st trimester that were most predictive of APO and to create the predictive model. A total of 217 pregnancies were included. One or more APO occurred in 45 (20.7%) women. A baseline model including non-Caucasian ethnicity (OR 2.78; 95% CI [1.16–6.62]), smoking (OR 4.43; 95% CI [1.74–11.29]), pregestational hypertension (OR 16.13; 95% CI [4.06–64.02]), and pregestational corticosteroids treatment OR 2.98; 95% CI [1.30–6.87]) yielded an AUC of 0.78 (95% CI, [0.70–0.86]). Among first-trimester parameters, only Pr/Cr ratio improved the model fit, but the predictive performance was not significantly improved (AUC of 0.78 vs. 0.81; p = 0.16). Better biomarkers need to be developed to efficiently stratify pregnant women with the most common autoimmune diseases.
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spelling pubmed-96969422022-11-26 Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome Baños, Núria Castellanos, Aleida Susana Barilaro, Giuseppe Figueras, Francesc Lledó, Gema María Santana, Marta Espinosa, Gerard J Clin Med Article A prospectively study of pregnant women with systemic lupus erythematosus (SLE), antiphospholipid syndrome, or non-criteria obstetric antiphospholipid syndrome was conducted to describe the characteristics of women followed in a referral unit and to derive a predictive tool for adverse pregnancy outcome (APO). Demographic characteristics, treatments, SLE activity, and flares were recorded. Laboratory data included a complete blood cell count, protein-to-creatinine urinary ratio (Pr/Cr ratio), complement, anti dsDNA, anti-SSA/Ro, anti-SSB/La, and antiphospholipid antibodies status. A stepwise regression was used to identify baseline characteristics available before pregnancy and during the 1st trimester that were most predictive of APO and to create the predictive model. A total of 217 pregnancies were included. One or more APO occurred in 45 (20.7%) women. A baseline model including non-Caucasian ethnicity (OR 2.78; 95% CI [1.16–6.62]), smoking (OR 4.43; 95% CI [1.74–11.29]), pregestational hypertension (OR 16.13; 95% CI [4.06–64.02]), and pregestational corticosteroids treatment OR 2.98; 95% CI [1.30–6.87]) yielded an AUC of 0.78 (95% CI, [0.70–0.86]). Among first-trimester parameters, only Pr/Cr ratio improved the model fit, but the predictive performance was not significantly improved (AUC of 0.78 vs. 0.81; p = 0.16). Better biomarkers need to be developed to efficiently stratify pregnant women with the most common autoimmune diseases. MDPI 2022-11-18 /pmc/articles/PMC9696942/ /pubmed/36431299 http://dx.doi.org/10.3390/jcm11226822 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Baños, Núria
Castellanos, Aleida Susana
Barilaro, Giuseppe
Figueras, Francesc
Lledó, Gema María
Santana, Marta
Espinosa, Gerard
Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome
title Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome
title_full Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome
title_fullStr Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome
title_full_unstemmed Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome
title_short Early Prediction of Adverse Pregnancy Outcome in Women with Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Non-Criteria Obstetric Antiphospholipid Syndrome
title_sort early prediction of adverse pregnancy outcome in women with systemic lupus erythematosus, antiphospholipid syndrome, or non-criteria obstetric antiphospholipid syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9696942/
https://www.ncbi.nlm.nih.gov/pubmed/36431299
http://dx.doi.org/10.3390/jcm11226822
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