Preconceptional Cardiovascular Health and Pregnancy Outcomes in Women with Systemic Lupus Erythematosus.

Autor:	Eudy AM; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. amanda.eudy@duke.edu.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine. amanda.eudy@duke.edu., Siega-Riz AM; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine., Engel SM; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine., Franceschini N; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine., Howard AG; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine., Clowse MEB; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine., Petri M; From the Department of Epidemiology, and the Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina; School of Nursing, University of Virginia, Charlottesville, Virginia; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; A.M. Eudy, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.M. Siega-Riz, PhD, School of Nursing, University of Virginia; S.M. Engel, PhD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; N. Franceschini, MD, Department of Epidemiology, University of North Carolina Chapel Hill Gillings School of Global Public Health; A.G. Howard, PhD, Department of Biostatistics, University of North Carolina Chapel Hill Gillings School of Global Public Health; M.E. Clowse, MD, MPH, Division of Rheumatology, Department of Medicine, Duke University Medical Center; M. Petri, MD, MPH, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2019 Jan; Vol. 46 (1), pp. 70-77. Date of Electronic Publication: 2018 Jul 15.
DOI:	10.3899/jrheum.171066
Abstrakt:	Objective: To estimate the effects of preconceptional cardiovascular (CV) health, measured by American Heart Association (AHA) guidelines, on pregnancy outcomes in women with systemic lupus erythematosus (SLE). Methods: The study included patients in the Hopkins Lupus Pregnancy Cohort. Body mass index (BMI), total cholesterol, and blood pressure (BP) in the most recent clinic visit prior to conception or first trimester were used to determine CV health (ideal, intermediate, or poor health) based on AHA definitions. Outcomes included preterm birth, gestational age at birth, and small for gestational age (SGA). Multivariable linear and logistic regression models with generalized estimating equations estimated the association of each CV health factor and outcome. Results: The analysis included 309 live births. There were 95 preterm births (31%), and of the 293 pregnancies with birth weights, 18% were SGA. Ideal BMI, total cholesterol, and BP were reported in 56%, 85%, and 51% of pregnancies, respectively. Intermediate BMI was associated with decreased odds of SGA (OR 0.26, 95% CI 0.11-0.63), adjusted for race and prednisone use. Intermediate/poor total cholesterol was associated with increased odds of preterm birth (OR 2.21, 95% CI 1.06-4.62). Intermediate/poor BP was associated with decreased gestational age at birth (β -0.96, 95% CI -1.62 to -0.29). Conclusion: Poor/intermediate preconception CV health affects pregnancy outcomes of preterm birth and SGA infants among women with SLE. Efforts to maintain BMI, total cholesterol, and BP within the recommended ideal range prior to pregnancy is important to improve pregnancy outcomes in women with SLE.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu