Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea
Identifieur interne : 000D23 ( Istex/Corpus ); précédent : 000D22; suivant : 000D24Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea
Auteurs : Eun-Jung Park ; Hyemin Jung ; Jiwon Hwang ; Hyungjin Kim ; Jaejoon Lee ; Joong Kyong Ahn ; Hoon-Suk Cha ; Eun-Mi KohSource :
- International Journal of Rheumatic Diseases [ 1756-1841 ] ; 2014-11.
Abstract
Objectives: To evaluates the pregnancy outcomes in systemic lupus erythematosus (SLE) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes. Methods: All pregnancies in SLE patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. SLE flares were determined by the Lupus Activity Index‐Pregnancy (LAI‐P) score. Results: Sixty‐two pregnancies were observed in 50 patients. Fifty‐one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty‐eight of the live births (74.5%) were full‐term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [OR] 12.50; P = 0.032). An LAI‐P score was obtained in 36 pregnancies, and SLE flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common SLE flare during pregnancy. All flares were classified as severe flare according to LAI‐P scores. SLE flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted OR 30.28; P = 0.024) and the presence of antiphospholipid antibodies (adjusted OR 6.62; P = 0.047). Conclusion: Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.
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DOI: 10.1111/1756-185X.12435
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title><author><name sortKey="Park, Eun Ung" sort="Park, Eun Ung" uniqKey="Park E" first="Eun-Jung" last="Park">Eun-Jung Park</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Jung, Hyemin" sort="Jung, Hyemin" uniqKey="Jung H" first="Hyemin" last="Jung">Hyemin Jung</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Hwang, Jiwon" sort="Hwang, Jiwon" uniqKey="Hwang J" first="Jiwon" last="Hwang">Jiwon Hwang</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Kim, Hyungjin" sort="Kim, Hyungjin" uniqKey="Kim H" first="Hyungjin" last="Kim">Hyungjin Kim</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Lee, Jaejoon" sort="Lee, Jaejoon" uniqKey="Lee J" first="Jaejoon" last="Lee">Jaejoon Lee</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Ahn, Joong Kyong" sort="Ahn, Joong Kyong" uniqKey="Ahn J" first="Joong Kyong" last="Ahn">Joong Kyong Ahn</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Cha, Hoon Uk" sort="Cha, Hoon Uk" uniqKey="Cha H" first="Hoon-Suk" last="Cha">Hoon-Suk Cha</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Koh, Eun I" sort="Koh, Eun I" uniqKey="Koh E" first="Eun-Mi" last="Koh">Eun-Mi Koh</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation><affiliation><mods:affiliation>: Eun‐Mi Koh, Professor, Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon‐dong, Gangnam‐gu, Seoul 135‐170, Korea.Email:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: eunmi.koh@samsung.com</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:18D3C859E6556071AA5835A7D4B648F0D12631C5</idno><date when="2014" year="2014">2014</date><idno type="doi">10.1111/1756-185X.12435</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-ZQ19P8B0-C/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000D23</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000D23</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title><author><name sortKey="Park, Eun Ung" sort="Park, Eun Ung" uniqKey="Park E" first="Eun-Jung" last="Park">Eun-Jung Park</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Jung, Hyemin" sort="Jung, Hyemin" uniqKey="Jung H" first="Hyemin" last="Jung">Hyemin Jung</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Hwang, Jiwon" sort="Hwang, Jiwon" uniqKey="Hwang J" first="Jiwon" last="Hwang">Jiwon Hwang</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Kim, Hyungjin" sort="Kim, Hyungjin" uniqKey="Kim H" first="Hyungjin" last="Kim">Hyungjin Kim</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Lee, Jaejoon" sort="Lee, Jaejoon" uniqKey="Lee J" first="Jaejoon" last="Lee">Jaejoon Lee</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Ahn, Joong Kyong" sort="Ahn, Joong Kyong" uniqKey="Ahn J" first="Joong Kyong" last="Ahn">Joong Kyong Ahn</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Cha, Hoon Uk" sort="Cha, Hoon Uk" uniqKey="Cha H" first="Hoon-Suk" last="Cha">Hoon-Suk Cha</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation></author><author><name sortKey="Koh, Eun I" sort="Koh, Eun I" uniqKey="Koh E" first="Eun-Mi" last="Koh">Eun-Mi Koh</name><affiliation><mods:affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation><affiliation><mods:affiliation>: Eun‐Mi Koh, Professor, Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon‐dong, Gangnam‐gu, Seoul 135‐170, Korea.Email:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: eunmi.koh@samsung.com</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">International Journal of Rheumatic Diseases</title><title level="j" type="alt">INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES</title><idno type="ISSN">1756-1841</idno><idno type="eISSN">1756-185X</idno><imprint><biblScope unit="vol">17</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="887">887</biblScope><biblScope unit="page" to="897">897</biblScope><biblScope unit="page-count">11</biblScope><date type="published" when="2014-11">2014-11</date></imprint><idno type="ISSN">1756-1841</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1756-1841</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Objectives: To evaluates the pregnancy outcomes in systemic lupus erythematosus (SLE) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes. Methods: All pregnancies in SLE patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. SLE flares were determined by the Lupus Activity Index‐Pregnancy (LAI‐P) score. Results: Sixty‐two pregnancies were observed in 50 patients. Fifty‐one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty‐eight of the live births (74.5%) were full‐term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [OR] 12.50; P = 0.032). An LAI‐P score was obtained in 36 pregnancies, and SLE flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common SLE flare during pregnancy. All flares were classified as severe flare according to LAI‐P scores. SLE flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted OR 30.28; P = 0.024) and the presence of antiphospholipid antibodies (adjusted OR 6.62; P = 0.047). Conclusion: Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Eun‐Jung Park</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Hyemin Jung</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Jiwon Hwang</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Hyungjin Kim</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Jaejoon Lee</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Joong Kyong Ahn</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Hoon‐Suk Cha</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string></affiliations></json:item><json:item><name>Eun‐Mi Koh</name><affiliations><json:string>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string><json:string>: Eun‐Mi Koh, Professor, Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon‐dong, Gangnam‐gu, Seoul 135‐170, Korea.Email:</json:string><json:string>E-mail: eunmi.koh@samsung.com</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>outcome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>pregnancy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>systemic lupus erythematosus</value></json:item></subject><articleId><json:string>APL12435</json:string></articleId><arkIstex>ark:/67375/WNG-ZQ19P8B0-C</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Objectives: To evaluates the pregnancy outcomes in systemic lupus erythematosus (SLE) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes. Methods: All pregnancies in SLE patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. SLE flares were determined by the Lupus Activity Index‐Pregnancy (LAI‐P) score. Results: Sixty‐two pregnancies were observed in 50 patients. Fifty‐one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty‐eight of the live births (74.5%) were full‐term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [OR] 12.50; P = 0.032). An LAI‐P score was obtained in 36 pregnancies, and SLE flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common SLE flare during pregnancy. All flares were classified as severe flare according to LAI‐P scores. SLE flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted OR 30.28; P = 0.024) and the presence of antiphospholipid antibodies (adjusted OR 6.62; P = 0.047). Conclusion: Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.</abstract><qualityIndicators><score>10</score><pdfWordCount>5488</pdfWordCount><pdfCharCount>36769</pdfCharCount><pdfVersion>1.6</pdfVersion><pdfPageCount>11</pdfPageCount><pdfPageSize>593.972 x 782.986 pts</pdfPageSize><pdfWordsPerPage>499</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>true</refBibsNative><abstractWordCount>254</abstractWordCount><abstractCharCount>1782</abstractCharCount><keywordCount>3</keywordCount></qualityIndicators><title>Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title><genre><json:string>article</json:string></genre><host><title>International Journal of Rheumatic Diseases</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1756-185X</json:string></doi><issn><json:string>1756-1841</json:string></issn><eissn><json:string>1756-185X</json:string></eissn><publisherId><json:string>APL</json:string></publisherId><volume>17</volume><issue>8</issue><pages><first>887</first><last>897</last><total>11</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Original Article</value></json:item><json:item><value>Original articles</value></json:item></subject></host><ark><json:string>ark:/67375/WNG-ZQ19P8B0-C</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - rheumatology</json:string></wos><scienceMetrix></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Rheumatology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2014</publicationDate><copyrightDate>2014</copyrightDate><doi><json:string>10.1111/1756-185X.12435</json:string></doi><id>18D3C859E6556071AA5835A7D4B648F0D12631C5</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-ZQ19P8B0-C/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-ZQ19P8B0-C/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-ZQ19P8B0-C/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher ref="https://scientific-publisher.data.istex.fr/ark:/67375/H02-QW5Q88H5-V">Wiley Publishing Ltd</publisher><availability><licence>© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd</licence></availability><date type="published" when="2014-11"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title><author xml:id="author-0000"><persName><forename type="first">Eun‐Jung</forename><surname>Park</surname></persName><affiliation><orgName type="division">Division of Rheumatology</orgName>
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OF</country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Hoon‐Suk</forename><surname>Cha</surname></persName><affiliation><orgName type="division">Division of Rheumatology</orgName>
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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract style="main" xml:id="apl12435-abs-0001"><head>Abstract</head><head>Objectives</head><p>To evaluates the pregnancy outcomes in systemic lupus erythematosus (<hi rend="fc">SLE</hi>) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes.</p><head>Methods</head><p>All pregnancies in <hi rend="fc">SLE</hi> patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. <hi rend="fc">SLE</hi> flares were determined by the Lupus Activity Index‐Pregnancy (<hi rend="fc">LAI</hi>‐P) score.</p><head>Results</head><p>Sixty‐two pregnancies were observed in 50 patients. Fifty‐one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty‐eight of the live births (74.5%) were full‐term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [<hi rend="fc">OR</hi>] 12.50; <hi rend="italic">P </hi>=<hi rend="italic"> </hi>0.032). An <hi rend="fc">LAI</hi>‐P score was obtained in 36 pregnancies, and <hi rend="fc">SLE</hi> flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common <hi rend="fc">SLE</hi> flare during pregnancy. All flares were classified as severe flare according to <hi rend="fc">LAI</hi>‐P scores. <hi rend="fc">SLE</hi> flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted <hi rend="fc">OR</hi> 30.28; <hi rend="italic">P </hi>=<hi rend="italic"> </hi>0.024) and the presence of antiphospholipid antibodies (adjusted <hi rend="fc">OR</hi> 6.62; <hi rend="italic">P </hi>=<hi rend="italic"> </hi>0.047).</p><head>Conclusion</head><p>Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.</p></abstract><textClass><keywords><term xml:id="apl12435-kwd-0001">outcome</term><term xml:id="apl12435-kwd-0002">pregnancy</term><term xml:id="apl12435-kwd-0003">systemic lupus erythematosus</term></keywords><keywords rend="articleCategory"><term>Original Article</term></keywords><keywords rend="tocHeading1"><term>Original articles</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-ZQ19P8B0-C/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="apl12435" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1111/(ISSN)1756-185X</doi><issn type="print">1756-1841</issn><issn type="electronic">1756-185X</issn><idGroup><id type="product" value="APL"></id></idGroup><titleGroup><title sort="INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES" type="main">International Journal of Rheumatic Diseases</title><title type="short">Int J Rheum Dis</title></titleGroup></publicationMeta><publicationMeta level="part" position="73"><doi origin="wiley">10.1111/apl.2015.17.issue-8</doi><copyright ownership="joint">International Journal of Rheumatic Diseases © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd</copyright><numberingGroup><numbering number="17" type="journalVolume">17</numbering><numbering type="journalIssue">8</numbering></numberingGroup><coverDate startDate="2014-11">November 2014</coverDate></publicationMeta><publicationMeta level="unit" position="90" status="forIssue" type="article"><doi>10.1111/1756-185X.12435</doi><idGroup><id type="unit" value="APL12435"></id></idGroup><countGroup><count number="11" type="pageTotal"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original articles</title></titleGroup><copyright ownership="publisher">© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd</copyright><eventGroup><event agent="SPS" date="2014-07-10" type="xmlCreated"></event><event type="publishedOnlineEarlyUnpaginated" date="2014-09-29"></event><event type="firstOnline" date="2014-09-29"></event><event type="publishedOnlineFinalForm" date="2015-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-06"></event></eventGroup><numberingGroup><numbering type="pageFirst">887</numbering><numbering type="pageLast">897</numbering></numberingGroup><correspondenceTo><lineatedText><line><i>Correspondence</i>: Eun‐Mi Koh, Professor, Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon‐dong, Gangnam‐gu, Seoul 135‐170, Korea.</line><line>Email: <email>eunmi.koh@samsung.com</email></line></lineatedText></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:APL.APL12435.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title><title type="shortAuthors">E.‐J. Park <i>et al</i>.</title></titleGroup><creators><creator affiliationRef="#apl12435-aff-0001" creatorRole="author" xml:id="apl12435-cr-0001"><personName><givenNames>Eun‐Jung</givenNames> <familyName>Park</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0001" creatorRole="author" xml:id="apl12435-cr-0002"><personName><givenNames>Hyemin</givenNames> <familyName>Jung</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0001" creatorRole="author" xml:id="apl12435-cr-0003"><personName><givenNames>Jiwon</givenNames> <familyName>Hwang</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0001" creatorRole="author" xml:id="apl12435-cr-0004"><personName><givenNames>Hyungjin</givenNames> <familyName>Kim</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0001" creatorRole="author" xml:id="apl12435-cr-0005"><personName><givenNames>Jaejoon</givenNames> <familyName>Lee</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0002" creatorRole="author" xml:id="apl12435-cr-0006"><personName><givenNames>Joong Kyong</givenNames> <familyName>Ahn</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0001" creatorRole="author" xml:id="apl12435-cr-0007"><personName><givenNames>Hoon‐Suk</givenNames> <familyName>Cha</familyName></personName></creator><creator affiliationRef="#apl12435-aff-0001" corresponding="yes" creatorRole="author" xml:id="apl12435-cr-0008"><personName><givenNames>Eun‐Mi</givenNames> <familyName>Koh</familyName></personName></creator></creators><affiliationGroup><affiliation countryCode="KP" type="organization" xml:id="apl12435-aff-0001"><orgDiv>Division of Rheumatology</orgDiv> <orgDiv>Department of Medicine</orgDiv> <orgName>Samsung Medical Center</orgName> <orgName>Sungkyunkwan University School of Medicine</orgName><address><city>Seoul</city> <country>Korea</country></address></affiliation><affiliation countryCode="KP" type="organization" xml:id="apl12435-aff-0002"><orgDiv>Division of Rheumatology</orgDiv> <orgDiv>Department of Medicine</orgDiv> <orgName>Kangbuk Samsung Hospital</orgName> <orgName>Sungkyunkwan University School of Medicine</orgName> <address><city>Seoul</city> <country>Korea</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="apl12435-kwd-0001">outcome</keyword><keyword xml:id="apl12435-kwd-0002">pregnancy</keyword><keyword xml:id="apl12435-kwd-0003">systemic lupus erythematosus</keyword></keywordGroup><abstractGroup><abstract type="main" xml:id="apl12435-abs-0001"><title type="main">Abstract</title><section xml:id="apl12435-sec-0001"><title type="main">Objectives</title><p>To evaluates the pregnancy outcomes in systemic lupus erythematosus (<fc>SLE</fc>) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes.</p></section><section xml:id="apl12435-sec-0002"><title type="main">Methods</title><p>All pregnancies in <fc>SLE</fc> patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. <fc>SLE</fc> flares were determined by the Lupus Activity Index‐Pregnancy (<fc>LAI</fc>‐P) score.</p></section><section xml:id="apl12435-sec-0003"><title type="main">Results</title><p>Sixty‐two pregnancies were observed in 50 patients. Fifty‐one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty‐eight of the live births (74.5%) were full‐term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [<fc>OR</fc>] 12.50; <i>P </i>=<i> </i>0.032). An <fc>LAI</fc>‐P score was obtained in 36 pregnancies, and <fc>SLE</fc> flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common <fc>SLE</fc> flare during pregnancy. All flares were classified as severe flare according to <fc>LAI</fc>‐P scores. <fc>SLE</fc> flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted <fc>OR</fc> 30.28; <i>P </i>=<i> </i>0.024) and the presence of antiphospholipid antibodies (adjusted <fc>OR</fc> 6.62; <i>P </i>=<i> </i>0.047).</p></section><section xml:id="apl12435-sec-0004"><title type="main">Conclusion</title><p>Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea</title></titleInfo><name type="personal"><namePart type="given">Eun‐Jung</namePart><namePart type="family">Park</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hyemin</namePart><namePart type="family">Jung</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jiwon</namePart><namePart type="family">Hwang</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hyungjin</namePart><namePart type="family">Kim</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jaejoon</namePart><namePart type="family">Lee</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joong Kyong</namePart><namePart type="family">Ahn</namePart><affiliation>Division of Rheumatology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hoon‐Suk</namePart><namePart type="family">Cha</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eun‐Mi</namePart><namePart type="family">Koh</namePart><affiliation>Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><affiliation>: Eun‐Mi Koh, Professor, Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon‐dong, Gangnam‐gu, Seoul 135‐170, Korea.Email:</affiliation><affiliation>E-mail: eunmi.koh@samsung.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2014-11</dateIssued><dateCreated encoding="w3cdtf">2014-07-10</dateCreated><copyrightDate encoding="w3cdtf">2014</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Objectives: To evaluates the pregnancy outcomes in systemic lupus erythematosus (SLE) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes. Methods: All pregnancies in SLE patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. SLE flares were determined by the Lupus Activity Index‐Pregnancy (LAI‐P) score. Results: Sixty‐two pregnancies were observed in 50 patients. Fifty‐one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty‐eight of the live births (74.5%) were full‐term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [OR] 12.50; P = 0.032). An LAI‐P score was obtained in 36 pregnancies, and SLE flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common SLE flare during pregnancy. All flares were classified as severe flare according to LAI‐P scores. SLE flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted OR 30.28; P = 0.024) and the presence of antiphospholipid antibodies (adjusted OR 6.62; P = 0.047). Conclusion: Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.</abstract><subject><genre>keywords</genre><topic>outcome</topic><topic>pregnancy</topic><topic>systemic lupus erythematosus</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Rheumatic Diseases</title></titleInfo><titleInfo type="abbreviated"><title>Int J Rheum Dis</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic><topic>Original articles</topic></subject><identifier type="ISSN">1756-1841</identifier><identifier type="eISSN">1756-185X</identifier><identifier type="DOI">10.1111/(ISSN)1756-185X</identifier><identifier type="PublisherID">APL</identifier><part><date>2014</date><detail type="volume"><caption>vol.</caption><number>17</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>887</start><end>897</end><total>11</total></extent></part></relatedItem><relatedItem type="references" displayLabel="apl12435-cit-0001"><titleInfo><title>A population‐based assessment of systemic lupus erythematosus incidence and prevalence–results and implications of using administrative data for epidemiological studies</title></titleInfo><name type="personal"><namePart type="given">S</namePart><namePart type="family">Bernatsky</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L</namePart><namePart type="family">Joseph</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CA</namePart><namePart type="family">Pineau</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R</namePart><namePart type="family">Tamblyn</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">DE</namePart><namePart type="family">Feldman</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">AE</namePart><namePart type="family">Clarke</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Bernatsky S, Joseph L, Pineau CA, Tamblyn R, Feldman DE, Clarke AE (2007) A population‐based assessment of systemic lupus erythematosus incidence and prevalence–results and implications of using administrative data for epidemiological studies. 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Ann Rheum Dis 69, 20–8.</note><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>69</number></detail><extent unit="pages"><start>20</start><end>8</end></extent></part><relatedItem type="host"><titleInfo><title>Ann Rheum Dis</title></titleInfo><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>69</number></detail><extent unit="pages"><start>20</start><end>8</end></extent></part></relatedItem></relatedItem><identifier type="istex">18D3C859E6556071AA5835A7D4B648F0D12631C5</identifier><identifier type="ark">ark:/67375/WNG-ZQ19P8B0-C</identifier><identifier type="DOI">10.1111/1756-185X.12435</identifier><identifier type="ArticleID">APL12435</identifier><accessCondition type="use and reproduction" contentType="copyright">International Journal of Rheumatic Diseases © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource><recordOrigin>Converted from (version ) to MODS version 3.6.</recordOrigin><recordCreationDate encoding="w3cdtf">2019-11-13</recordCreationDate></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-ZQ19P8B0-C/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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