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[Perinatal morbidity and mortality secondary to systemic lupus erythematosus in a tertiary care institution]
L M Arroyo Cabrales1, J Guzmán Bárcenas, S Romero Maldonado
1Instituto Nacional de Perinatología, Unidad de Cuidados Intermedios del Recién Nacido, Lomas Virreyes, México, D.F.
Introduction:
Autoimmune diseases occur more often in procreation age women, being systemic lupus erythematosus (SLE) a multisystemic, chronic inflammatory illness, the prototype of them.
Objective:
Evaluate the behavior of perinatal morbidity/mortality in a group of pregnant patients, identifying maternal and secondary neonatal complications secondary to SLE.
Material And Methods:
Between January 1992 and December 1997, seventy two cases of maternal SLE were seen at the Instituto Nacional de Perinatología in Mexico City. Maternal and neonatal files were reviewed retrospectively in search of maternal and neonatal complications secondary to SLE.
Results:
Maternal SLE diagnosis was confirmed in all cases: Ideal reproductive age was seen in 84.7% and extreme ages in 15.3% of the maternal population. Effective prenatal control was carried out in 87% of the pregnancies and 16.6% required at least one hospitalization during gestation. The most frequent complications were infectious (37.5%), haematologic (13.9%) and renal (5.5%). No mortality was seen in the maternal population. Normal weight for gestational age was seen in 58.3% of the neonates and low weight for gestational age in 41.6%; prematurity was seen in the same percentage (41.6%). The most frequent complications in the neonatal population were haematologic (18.0), respiratory (12.5%), metabolic (8.3%) and heart block and cutaneous lesions (1.4%). Neonatal lupus was diagnosed in 8.3%, and survival was of 94.4%).
Discussion:
Maternal and neonatal morbidity secondary to SLE was seen in less than 50% of the cases. Infectious complications, the most frequent in the maternal population, is probably secondary to medical treatment. Of the patients with neonatal lupus only 2.8% had heart block and cutaneous lesions. Maternal outcome and neonatal repercussion of maternal SLE do not differ in relation to other authors results. However it is necessary to evaluate the immunologic behavior and genetic predisposition because each population has a different of HLA antigens.