Kroese, S.J. (2015) The challenges of pregnancy in patients with systemic lupus erythematosus :Is there a role for hydroxychloroquine? thesis, Medicine.
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Abstract
Introduction: Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune, connective-tissue disease that affects various organs including joints, skin and kidneys. Pregnancy within these patients is a challenge since they are at an increased risk of lupus flares, preeclampsia, spontaneous miscarriage and preterm delivery. The antimalarial drug hydroxychloroquine (HCQ) appears to improve disease activity during pregnancy. The purpose of this study was to investigate the effects of HCQ on lupus activity during pregnancy and preterm live birth (PTLB). Methods: This was a retrospective study of pregnancies in women with SLE between 2000 and 2014. Data were extracted from medical charts and pregnancies were analyzed grouped in HCQ use or non-use. Lupus activity during pregnancy using SLEDAI scores, pregnancy outcomes and maternal and foetal outcomes were analyzed between these groups. Results: Sixty-four SLE patients with 113 pregnancies were included; 33 pregnancies were within the HCQ-group versus 80 in the non-HCQ group. SLEDAI scores and frequency of flares during pregnancy did not significantly differ between HCQ use and non-use. There were no significant differences in the occurrence of PTLB between the two groups. The use of HCQ was associated with higher gestational age within the PTLB group and with lower doses of prednisone during pregnancy. Conclusion: In our cohort HCQ use is not associated with lower disease activity or less PTLB. Our data support the use of HCQ during pregnancy in SLE patients as it is associated with a higher gestational age in PTLB and lower doses of prednisone during pregnancy.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty tutor: and Nijholt, Dr. I.M. affiliation coordinator |
| Supervisor name: | Clinical tutor: and Fritsch-Stork, R.D.E. MD and Department of Rheumatology and Clinical Immunology, UMC Utre |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:06 |
| Last Modified: | 25 Jun 2020 11:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2606 |
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