Pregnancy outcomes and contraceptive use in patients with systemic lupus Erythematosus, rheumatoid arthritis and women without a chronic illness: a comparative study

Autor: Lalith S. Wijayaratne, Sampath C. Paththinige, Jayan D. D. Jayasinghe, Priyadarshani Galappatthy, Rezvi Sheriff
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Time Factors
Adolescent
Arthritis
Rheumatoid
Tertiary Care Centers
03 medical and health sciences
Young Adult
0302 clinical medicine
Rheumatology
immune system diseases
Pregnancy
Risk Factors
Internal medicine
medicine
Contraceptive Agents
Female
Humans
Lupus Erythematosus
Systemic
030212 general & internal medicine
Young adult
skin and connective tissue diseases
Contraception Behavior
Retrospective Studies
Sri Lanka
030203 arthritis & rheumatology
Systemic lupus erythematosus
Chi-Square Distribution
business.industry
Pregnancy Outcome
Pregnancy
Unplanned
Retrospective cohort study
Middle Aged
medicine.disease
Pregnancy Complications
Low birth weight
Rheumatoid arthritis
Physical therapy
Disease Progression
Female
medicine.symptom
business
Live birth
Live Birth
Zdroj: International journal of rheumatic diseases. 20(6)
ISSN: 1756-185X
Popis: Objectives To compare the pregnancy outcomes and contraceptive practices in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and women with no chronic illness (WNCI) in a tertiary care referral center in Colombo, Sri Lanka. Methods Patients with SLE satisfying American College of Rheumatology criteria for diagnosis and history of pregnancies were recruited from university lupus clinic, National Hospital of Sri Lanka (NHSL). Age-matched women with history of pregnancy and RA were recruited from the rheumatology clinic, NHSL and WNCI from a surgical clinic. Results In 71 patients with SLE, 79 pregnancies occurred in 38 patients. The number of total pregnancies in SLE, RA and WNCI (79, 80 and 85 respectively) were not significantly different (P > 0.05), but most occurred before diagnosis of SLE and RA. Pregnancies occurring after diagnosis were significantly higher in SLE compared to RA (P = 0.013, χ2 = 6.169). Mean age at diagnosis was higher (P < 0.01) in RA (35 years) than in SLE (26 years). Percentage live births after diagnosis was significantly lower (P < 0.01) in SLE (9/20; 45%) compared to RA (6/8; 75%) and WNCI (77/85; 91%). Adverse fetal outcomes (fetal loss, pre-maturity, low birth weight) and assisted deliveries were significantly more (P < 0.001) in SLE than in WNCI. Unplanned pregnancies were significantly higher (P < 0.01) in SLE (80%) compared to RA (25%) and in WNCI (9.4%). Contraceptive usage was lower in patients with SLE (25.6%) and RA (33%) compared to WNCI (56.4%). Disease exacerbations occurred in 20% of SLE patients during pregnancy. Conclusions More pregnancies occur in SLE than in RA after diagnosis of illness. Unplanned pregnancies and adverse pregnancy outcomes need to be addressed more in SLE than in RA or in WNCI.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje