血管炎的孕产妇和产周结局:在葡萄牙高等多学科中心进行了为期15年的研究
Ana Rita Lopes1,2, Susana Capela1,2, Ana Rita Cruz-Machado1,2
1Rheumatology Department, ULS Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal.
Rheumatology advances in practice
|February 5, 2026
概括
患有血管炎的女性的怀孕可以成功,如果疾病处于缓解期. 然而,使用普得尼索隆和疾病复发会增加不良妊娠结果 (APO) 的风险.
科学领域:
- 类风湿病学 类风湿病学
- 产科 产科 产科 产科 产科
- 周围生理学 周围生理学
背景情况:
- 系统性血管炎在怀孕期间带来了独特的挑战.
- 了解孕产妇和产周结果对于管理这些高风险怀孕至关重要.
研究的目的:
- 评估患有血管炎的妇女的孕产妇和产周期结局.
- 在这个人群中识别与不良妊娠结果 (APO) 相关的风险因素.
主要方法:
- 一项对28名患有系统性血管炎的妇女39次怀孕的回顾性研究 (2009-2024年).
- 收集的数据包括患者特征,疾病活动 (缓解/复发),治疗和怀孕结果.
- 负面的妊娠结果 (APOs) 包括流产,死胎,早产,胎儿生长限制 (FGR),对于妊娠年龄来说小 (SGA) 和子宫前.
- 统计分析涉及单变量和多变量逻辑回归来确定风险因素.
主要成果:
- 大多数怀孕 (92.3%) 发生在临床缓解期间.
- 常见的血管炎亚型包括贝赫特病,多关节炎和塔卡亚苏动脉炎.
- 在33.3%的怀孕中发生了不良妊娠结果 (APOs).
- 普雷尼索隆使用 (OR 26.10) 和怀孕期间疾病复发 (OR 8.90) 独立地与APO相关.
- 没有发现与母亲年龄,累计普得尼松剂量或免疫抑制剂使用的显著关联.
- 没有报告母亲死亡或严重的新生儿并发症.
结论:
- 患有血管炎的女性的怀孕可以成功,特别是当怀孕发生在临床缓解期间时.
- 在怀孕期间使用普雷尼索隆和疾病复发是不良妊娠结果 (APO) 的潜在危险因素.
- 预孕咨询和多学科护理对于优化血管炎孕妇的结果至关重要.
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