系统性红斑狼疮女性患者再分娩对母婴结局的影响  

Effect of reproduction on maternal and infant outcomes in female patients with systemic lupus erythematosus

作　　者：邵树铭 张懿敏 张晓蕊[1] 刘捷[1] 曾超美[1] Shao Shuming;Zhang Yimin;Zhang Xiaorui;Liu Jie;Zeng Chaomei(Department of Pediatrics,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院儿科,100044

出　　处：《中华实用儿科临床杂志》2021年第18期1403-1406,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：北京市卫生健康委员会北京市临床重点专科项目(2018)。

摘　　要：目的探讨系统性红斑狼疮(SLE)女性患者再次分娩对母婴结局的影响。方法回顾性分析2015年7月至2019年12月北京大学人民医院收治的SLE并妊娠患者的临床资料,根据是否有活产分娩史,将患者分为初产组(94例)及再产组(32例),分析2组的母婴结局。结果共纳入SLE并妊娠患者126例,再产组较初产组产妇应用免疫抑制剂的比例显著降低[3例(9.38%)比27例(28.72%)],差异有统计学意义(χ^(2)=4.927,P=0.026);再产组并狼疮性肾炎及甲状腺疾病、产后出血等合并症及并发症较初产组增多,早产儿、低出生体质量儿、小于胎龄儿等不良新生儿结局较初产组减少,但差异均无统计学意义(均P>0.05);两组间新生儿首次血常规检查结果及新生儿病理性黄疸发生率差异均无统计学意义(均P>0.05)。结论SLE并妊娠患者再次分娩时虽部分妊娠期合并症及并发症发生率增高,但新生儿不良结局发生率减少。此外,减少免疫抑制剂的使用可能对新生儿结局有积极意义。Objective To investigate the effect of reproduction on maternal and infant outcomes in female patients with systemic lupus erythematosus(SLE).Methods Clinical data of SLE patients complicated with pregnancy admitted in the Peking University People′s Hospital from July 2015 to December 2019 were analyzed retrospectively.According to the history of live birth,SLE patients complicated with pregnancy were divided into primiparity group(94 cases)and reproduction group(32 cases).Maternal and infant outcomes of the 2 groups were analyzed.Results A total of 126 SLE patients complicated with pregnancy were included in the present study.The proportion of using immunosuppressants was significantly lower in reproduction group than that of primiparity group[3 cases(9.38%)vs.27 cases(28.72%)](χ^(2)=4.927,P=0.026).Complications like lupus nephritis,thyroid disease and postpartum hemorrhage significantly increased in the reproduction group(all P<0.05),and the adverse neonatal outcomes like preterm infants,low birth weight infants and small for gestational age infants in the reproduction group were lower than those in primiparity group,but no significant differences were detected(all P>0.05).There were no significant diffe-rences in the results of the first blood routine examination of newborns and the incidence of neonatal pathological jaundice between the 2 groups(all P>0.05).Conclusions For SLE patients complicated with reproductive pregnancy,although the incidence of some pregnancy complications increases,the incidence of adverse neonatal outcomes decreases.In addition,reducing the use of immunosuppressants may have positive implications on neonatal outcomes.

关 键 词：系统性红斑狼疮 再分娩 母婴结局 

分 类 号：R714.25[医药卫生—妇产科学] R593.241[医药卫生—临床医学]