Fetal and maternal outcome in patients with active lupus nephritis: comparison between new-onset and pre-existing lupus nephritis

BMC Nephrology

Li Fan¹  Xing-Ji Lian¹  Xia-Min Huang¹  Xi Xia¹  Hong-Jian Ye¹  Wei Chen¹  Xue-Qing Yu²  Hai-Tian Chen³ 

[1] Department of Nephrology, The First Affiliated Hospital, NHC Key Laboratory of Nephrology, Guangdong Provincial Key Laboratory of Nephrology, Sun Yat-sen University, No. 58 Zhongshan Er Lu, 510080, Guangzhou, China;Department of Nephrology, The First Affiliated Hospital, NHC Key Laboratory of Nephrology, Guangdong Provincial Key Laboratory of Nephrology, Sun Yat-sen University, No. 58 Zhongshan Er Lu, 510080, Guangzhou, China;Division of Nephrology, Guangdong Provincial People’s Hospital and Guangdong Academy of Medical Sciences, 510080, Guangzhou, China;Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Lu, 510080, Guangzhou, Guangdong, China;

关键词: lupus nephritis;    glomerulonephritis;    kidney disease outcome;    pregnancy outcome;    new-onset;   

DOI  :  10.1186/s12882-021-02633-2

来源: Springer

【 摘 要 】

BackgroundThis study aimed to investigate fetal and maternal outcomes in women with active lupus nephritis (LN). Specifically, we compared women who had new-onset LN and those with pre-existing LN during pregnancy.MethodsPatients with active LN during pregnancy were divided into the new-onset group (LN first occurred during pregnancy) and the pre-existing group (a history of LN) on the basis of the onset time of LN. Data on clinical features, laboratory findings, and pregnancy outcome were collected and analyzed between the two groups. Multivariate logistic regression analysis was used to compare the effects of active LN on adverse pregnancy outcomes.ResultsWe studied 73 pregnancies in 69 women between 2010 and 2019. Of these, 38 pregnancies were in the pre-existing LN group and 35 were in the new-onset group. Patients with pre-existing LN had a higher risk of composite adverse fetal outcomes than those with new-onset LN [adjusted odds ratio (ORs), 44.59; 95% confidence interval (CI), 1.21–1664.82; P = 0.039]. However, the two groups had similar adverse maternal outcomes (ORs, 1.24; 95% CI, 0.36–4.29). Serum albumin and proteinuria significantly improved after pregnancy (P < 0.001). Kaplan–Meier analysis showed that the long-term renal outcome was similar between the two groups.ConclusionsPregnant patients with pre-existing LN were associated with a higher risk of composite adverse fetal outcomes than those with new-onset LN. However, these two groups of patients had similar adverse maternal outcomes. The long-term renal outcomes were not different after pregnancy between these two groups.

【 授权许可】

CC BY