Análise dos desfechos maternos, fetais e neonatais na gestação de pacientes com lúpus eritematoso sistêmico

Abstract

Pregnancy in women with lupus is a subject that has been studied for decades because of the potential maternal, fetal and neonatal complications that can occur. Currently, we observe an increase in the number of successful pregnancies and a decrease in fetal loss rates, but there is still limited effectiveness in preventing other complications and the association of SLE with pregnancy continues to be considered high risk and may have a poor prognosis. The aim of this thesis was to evaluate pregnancy outcomes in a cohort of pregnant women with systemic lupus erythematosus, focusing on the impact of lupus nephritis, especially proliferative glomerulonephritis (GNP) and knowledge of permanent damage (SDI) accumulated prior to pregnancy, as factors of risk associated with adverse maternal, fetal and neonatal outcomes. Study 1 analyzed the maternal clinical and laboratory variables potentially associated with the occurrence of small-for-gestational age (SGA) newborns, and demonstrated that the activity of SLE during pregnancy, specifically proliferative nephritis and the use of pulse therapy with methylpredinisolone were independent risk predictors for small-for-gestational-age newborns. Study 2 analyzed the impact of the presence of permanent damage in pregnant women with SLE and showed that there is an association between permanent damage and adverse pregnancy outcomes.