Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study

 

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dc.contributor.advisor Okpechi, Ikechi en_ZA
dc.contributor.author Mbuli, Lindisa en_ZA
dc.date.accessioned 2016-02-02T13:46:28Z
dc.date.available 2016-02-02T13:46:28Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Mbuli, L. 2015. Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16679
dc.description Includes bibliographical references en_ZA
dc.description.abstract Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease commonly affecting females of child-bearing age, hence hormonal changes in pregnancy are thought to play a role in disease activity - often necessitating changes in immunosuppression therapy. SLE is common in Cape Town, however, the effect of pregnancy on SLE and vice versa has not been well characterised. The aim of this study is to report on the pregnancy outcomes of patients with SLE presenting to the maternity department of Groote Schuur Hospital, Cape Town. Methods: This study was designed as a retrospective review of records of pregnant women known with SLE and followed up at the maternity section of Groote Schuur Hospital. The duration of the survey was from 1 January 2003 to 31 December 2013. Records were identified using the attendance registers in the relevant departments. Results: There were 61 pregnancies reviewed in 49 patients; 80.3% of the pregnancies were in patients of mixed ancestry and the rest (19.7%) in black African patients. The mean age at presentation of the current pregnancy was 27215.0 years. Mean gestational age at presentation and delivery was 13.0 ± 6.0 weeks and 28.9 ± 9.8 weeks respectively and 47.5% of the pregnancies were in patients with lupus nephritis (LN). Thirty-nine (63.9%) pregnancies reached the third trimester and 11.5% of all pregnancies ended in the first trimester. There was a lower number of live births to mothers of African ancestry than to those of mixed ancestry (p=0.001). In 55.7% of the pregnancies, no flare was reported while a renal flare was reported in 23%. Pregnancies in patients with LN had higher frequencies of flares (58.6% vs 31.3%; p=D.O32), pre-eclampsia (34.5% vs 12.5%; p=D.O41), longer stay in hospital (12.0 ± 9.1 days vs 6.1 ± 5.1 days; p=0.DO-4) and low birth weight babies (1.94 ± 1.02 kg vs 2.55 ± 0.95 kg; p=D.O46) than in patients without LN. Only 36 (59%) of the neonates were discharged home alive and of these 2 (5.6%) were to mothers of black African ancestry (p=0.001). Conclusion: Increased lupus activity in pregnant SLE patients may account for the increased deaths of neonates born to SLE mothers. Patients of black African descent and those with LN tend to have a poorer outcome. A multi-disciplinary approach to the management of SLE patients (of child-bearing age or pregnant) needs to be further evaluated. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Medicine en_ZA
dc.subject.other Systemic lupus erythematosus en_ZA
dc.title Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study en_ZA
dc.type Master Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Nephrology and Hypertension en_ZA
dc.type.qualificationlevel Masters
dc.type.qualificationname MMed en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Mbuli, L. (2015). <i>Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension. Retrieved from http://hdl.handle.net/11427/16679 en_ZA
dc.identifier.chicagocitation Mbuli, Lindisa. <i>"Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension, 2015. http://hdl.handle.net/11427/16679 en_ZA
dc.identifier.vancouvercitation Mbuli L. Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16679 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Mbuli, Lindisa AB - Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease commonly affecting females of child-bearing age, hence hormonal changes in pregnancy are thought to play a role in disease activity - often necessitating changes in immunosuppression therapy. SLE is common in Cape Town, however, the effect of pregnancy on SLE and vice versa has not been well characterised. The aim of this study is to report on the pregnancy outcomes of patients with SLE presenting to the maternity department of Groote Schuur Hospital, Cape Town. Methods: This study was designed as a retrospective review of records of pregnant women known with SLE and followed up at the maternity section of Groote Schuur Hospital. The duration of the survey was from 1 January 2003 to 31 December 2013. Records were identified using the attendance registers in the relevant departments. Results: There were 61 pregnancies reviewed in 49 patients; 80.3% of the pregnancies were in patients of mixed ancestry and the rest (19.7%) in black African patients. The mean age at presentation of the current pregnancy was 27215.0 years. Mean gestational age at presentation and delivery was 13.0 ± 6.0 weeks and 28.9 ± 9.8 weeks respectively and 47.5% of the pregnancies were in patients with lupus nephritis (LN). Thirty-nine (63.9%) pregnancies reached the third trimester and 11.5% of all pregnancies ended in the first trimester. There was a lower number of live births to mothers of African ancestry than to those of mixed ancestry (p=0.001). In 55.7% of the pregnancies, no flare was reported while a renal flare was reported in 23%. Pregnancies in patients with LN had higher frequencies of flares (58.6% vs 31.3%; p=D.O32), pre-eclampsia (34.5% vs 12.5%; p=D.O41), longer stay in hospital (12.0 ± 9.1 days vs 6.1 ± 5.1 days; p=0.DO-4) and low birth weight babies (1.94 ± 1.02 kg vs 2.55 ± 0.95 kg; p=D.O46) than in patients without LN. Only 36 (59%) of the neonates were discharged home alive and of these 2 (5.6%) were to mothers of black African ancestry (p=0.001). Conclusion: Increased lupus activity in pregnant SLE patients may account for the increased deaths of neonates born to SLE mothers. Patients of black African descent and those with LN tend to have a poorer outcome. A multi-disciplinary approach to the management of SLE patients (of child-bearing age or pregnant) needs to be further evaluated. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study TI - Maternal and foetal outcomes of patients with systematic lupus erythematosus admitted to the Maternity Ward at Groote Schuur Hospital: A retrospective study UR - http://hdl.handle.net/11427/16679 ER - en_ZA


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