ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2018, Vol. 27 ›› Issue (4): 315-319.DOI: 10.3969/j.issn.1006-298X.2018.04.004

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Pregnancy and neonatal outcomes in lupus nephritis patients with complete remission

  

  • Online:2018-08-28 Published:2018-08-31

Abstract:

Objective:To analyze the risk factors of lupus flares,pregnancy and neonatal complications in lupus nephritis (LN) patients who achieving complete remission.
Methodology:One hundred female LN patients who achieved complete remission (remission group) prior to conception were collected in our unit from 2010 to 2016.27 LN patients who had not achieved remission and had unplanned pregnancies were collected as the control group.LN relapse rate,maternal and neonatal complications were analyzed and compared between the remission and control groups.
Results:During 104 pregnancies in  remission group,LN relapse developed in 15 (144%) pregnancies.In the control group,lupus relapse occurred in 21 (778%) pregnancies which was higher than remission group.For remission group,the lupus relapse was predicted by LN remission time of <12m and positive antiC1q antibody before pregnancy.There were 37 patients(356%) who encountered pregnancy or neonatal complications.96 newborns survived without any complications and defects.During 27 pregnancies in the control group,pregnancy or neonatal complications developed in 23 pregnancies (852%).22 neonates were survived without any complications and defects.The   preterm delivery rate in remission group was lower than that in the control group.For remission group,the preterm delivery was predicted by LN remission time of <6 m,the fetal loss is predicted by hypocomplementaemia before pregnancy and the positive antiphospholipid antibodies.The lower level of eGFR,the risk of intrauterine growth retardation is much higher.
Conclusion:
Complete remission prior to pregnancy showed good pregnancy and neonatal outcomes in patients with lupus nephritis.