北京大学学报（医学版）2025，Vol.57Issue(3)：599-603,5.DOI:10.19723/j.issn.1671-167X.2025.03.026
系统性红斑狼疮患者不良妊娠结局的预测因素
Predictors of adverse pregnancy outcomes in patients with systemic lupus erythemato-sus
摘要
Abstract
Objective:To identify predictors of adverse pregnancy outcomes(APOs)in patients with systemic lupus erythematosus(SLE).Methods:A retrospective analysis was conducted on 318 SLE pa-tients who delivered at Peking University People's Hospital from May 2016 to September 2021.These pa-tients were categorized into two groups:The APOs group(n=85)and the non-APOs group(n=233).Various factors,including disease duration,clinical manifestations,laboratory parameters,and systemic lupus erythematosus disease activity index 2000(SLED AI-2000)scores,were analyzed for their associa-tion with APOs.SPSS 26.0 software was used to analyze the data.Results:The mean age of SLE pa-tients in this study was(24.65±5.26)years.Among the 318 pregnancies studied,302(302/318,94.97％)resulted in live births,while 16(16/318,5.03％)cases ended in stillbirths,with no neonatal deaths reported.Among the live births,206(206/302,68.21％)were full-term infants,65(65/302,21.52％)cases were small for gestational age(SGA),and 31(31/302,10.26％)cases were preterm.The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group(5.82±4.97 vs.3.74±3.72,t=4.019,P=0.001),suggesting greater disease activity as a risk fac-tor.Similarly,glucocorticoid doses were markedly higher in the APOs group[12.50(7.50,50.00)mg vs.10.00(5.00,15.00)mg,P＜0.001],underscoring the link between disease severity and APOs.Univariate analysis revealed that lupus nephritis(31.76％vs.21.03％,x2=3.946,P=0.047),throm-bocytopenia(24.71％vs.9.01％,x2=13.380,P＜0.001),hypocomplementemia(36.47％vs.26.03％,x2=4.847,P=0.028),antiphospholipid antibody positivity(20.00％vs.11.16％,x2=4.163,P=0.041),and absence of pregnancy treatment(21.18％vs.11.59％,x2=4.713,P=0.030)were associated with increased APOs risk.Multivariate Logistic regression identified thrombocyto-penia(OR=2.671,95％CI:1.309-5.449,P=0.007),hypocomplementemia(OR=1.935,95％CI:1.104-3.393,P=0.021),and antiphospholipid antibody positivity(OR=2.153,95％CI:1.054-4.399,P=0.035)as independent predictors of APOs.Conclusion:These findings highlight that certain clinical and laboratory features,including thrombocytopenia,hypocomplementemia,and antiphospholipid antibody positivity,are critical independent predictors of APOs in SLE patients.The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.关键词
系统性红斑狼疮/不良妊娠结局/预测因素Key words
Systemic Lupus Erythematosus/Adverse pregnancy outcomes/Predictors分类
医药卫生引用本文复制引用
王文琼,侯玉珂,李春,张学武..系统性红斑狼疮患者不良妊娠结局的预测因素[J].北京大学学报（医学版）,2025,57(3):599-603,5.基金项目
中华国际医学交流基金会基金(Z-2018-40-2101)Supported by China International Medical Foundation(Z-2018-40-2101) （Z-2018-40-2101）
