Estudo dos fatores de risco associados a infecções em gestantes com lúpus eritematoso sistêmico

Abstract

Pregnant women with Systemic Lupus erythematosus (SLE) have risk factors related to pregnancy and the underlying disease that predispose to infection. The objetctive is to analyze the occurrence and risk factors associated with infections during pregnancy in patients with systemic lupus erythematosus (SLE). Retrospective cohort study using the data of pregnant women followed up between 2011 and 2019 at a university hospital. A total of 254 pregnant women with SLE were analyzes and infections. Bi and multivariate analyzes were performed to determine the aassociation between clinica variables and infections occurred in 24.8% (63/254). The urinary tract was the most frequent, with 16.5% (42/254) of the total number of pregnant women, followed by the respiratory tract with 7.9% (20/254). The mean age at diagnosis of SLE was 20.4 ± 6.0 years. In the bivariate analysis, the use of prednisone ate the beginning and at the end of pregnancy was associated with a higher chance of infection (p=0.03 and p+0.01). A dose ≥ 5mg/day of prednisone used at the begnning and at the end of pregnancy increased the chance of infection in general (p=0.03 and p=0.02) when used in early pregnancy, it was associated with urinary tract’s infection (p=0.02). A dose ≥ 10mg in early pregnancy was associated with respiratory infection (p=0.01). When used at the end of pregnancy, azathioprine (AZA) and prednisone were associated with respiratory infection (p=0.02 and p=0.02). Disease activity, presence of anti-DNA antibody and cumulative prednisone dose at the end og pregnancy were associated with a higher number of general infections (p=0.006, p=0.005 and p=0.01). In the multivariate analysis, disease activity was associated with a two-fold increase in the chance of developing infections in pregnant women with SLE (Ora=2.3 (1.07-4.97); p=0.03). The study showed an increased risk of infections in pregnant women with SLE.