Risk of gestational diabetes mellitus in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis

BMC Pregnancy and Childbirth

Dongqing Ye¹  Hong Wang¹  Yuanyuan Dong¹  Ziwei Dai¹  Zhihui Wang¹  Feifei Yuan¹  Bin Wang¹  Ying Zhu² 

[1] 0000 0000 9490 772X, grid.186775.a, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, 230032, Hefei, Anhui, China;0000 0000 9490 772X, grid.186775.a, The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, 230032, Hefei, Anhui, China;0000 0004 1771 3402, grid.412679.f, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, 230032, Hefei, Anhui, China;

关键词: Systemic lupus erythematosus;    Pregnancy;    Glucocorticoids;    Gestational diabetes mellitus;   

DOI  :  10.1186/s12884-019-2329-0

来源: publisher

【 摘 要 】

BackgroundIt is well established that the risks of insulin resistance and diabetes mellitus are elevated in systemic lupus erythematosus (SLE) patients. However, the relationship between SLE pregnancy and gestational diabetes mellitus (GDM) is still obscure. We perform the present systematic review and meta-analysis to determine the relationship between GDM and SLE pregnancy.MethodsAccording to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, relevant studies were carefully retrieved through PubMed, Cochrane library and Web of Science, China National Knowledge Infrastructure, Wanfang database and China Biology Medicine database from inception till 30 August 2018. GDM risk ratio (RR) of pregnant SLE patients versus controls was calculated to evaluate the association between GDM and SLE. Pooled RRs and 95% confidence intervals (CIs) were calculated using random effects model by R software.ResultsThe literature retrieval identified 339 potential studies in total, and five studies containing 3432 pregnant participants with 248 GDM events were included finally. Pooled analysis found that the risk of GDM were not significant increased in SLE patients compared to controls (RR = 1.08, 95% CI = 0.49 to 2.41, Z = 0.19 and P = 0.848). Nevertheless, meta-regression identified that glucocorticoids use and anti-double stranded DNA antibodies positive of SLE patients were positively associated with the risk of GDM.ConclusionsOur meta-analysis demonstrated that SLE pregnancy may not increase the risk of GDM, but the steroid use during pregnancy was associated with increased risk of GDM. Further large prospective and basic immunologic studies should be implemented for exploring the mechanism underlying glucocorticoids use and GDM.

【 授权许可】

CC BY