New-Onset Systemic Lupus Erythematosus and Pregnancy: A Systematic Review

作     者：SUMISTI SHAKYA 

作者单位：重庆医科大学 

学位级别：硕士

导师姓名：ZHU YANG

授予年度：2016年

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主      题：系统性红斑狼疮 怀孕时期 并发症 

摘      要：BackgroundSystemic lupus erythematosus（SLE） is a chronic, multi-organ autoimmune disease that occurs predominantly among reproductive age women. When SLE is newly diagnosed during pregnancy or puerperium, it is known as new-onset SLE during pregnancy. The diagnosis of new-onset SLE tends to be delayed or missed diagnosed due to similar clinical feature presentation with normal physiological changes and common pathological disease（preeclampsia） encountered during pregnancy. Furthermore, new-onset SLE during pregnancy has major organ involvement with poor maternal and fetal outcomes. In addition, certain lupus medications are potentially teratogenic and are contraindicated during *** objective of this systematic review is to investigate the clinical features, laboratory findings, treatment, complications and outcomes of new-onset SLE during *** methodsSystematic reviewThe MEDLINE, EMBASE, Pub Med, SCOPUS data bases related to new-onset SLE were searched up to February *** review comprises of results of 21 studies;16 were case reports published between year 1994-2016 and remaining being retrospective study published between year 2005-2015. A total of 149 patients with new-onset SLE during pregnancy were identified and studied their course of disease. The mean maternal age of diagnosis of SLE was in their mid 20’s. The new-onset SLE generally have more severe disease with higher prevalence of renal and hematological involvement, which might have significant impact on health of mother and fetus. The most common maternal complication was preeclampsia. When lupus was missed diagnose with preeclampsia especially during third trimester it tended to delay diagnosis for 5 days to more than 12 months after delivery. Despite vigorous treatment with glucocorticoids and/or immunosupprestant, the outcome is poor with fetal loss, spontaneous abortion, preterm birth, maternal death and severe organ *** and awarenes