Good outcomes in 10-year data on lupus in pregnancy: thrombocytopenia at conception key factor.(News)

SAN FRANCISCO -- The risk for preeclampsia in pregnant women with lupus tripled if they had thrombocytopenia at conception, according to a review of data from a 10-year period at one institution.

This previously unreported finding was highly statistically significant, but prospective studies will be needed to confirm the association, study investigator Maurice L. Druzin, M.D., said at a meeting on antepartum and intrapartum management, sponsored by the University of California, San Francisco.

"We certainly are going to be looking at patients with thrombocytopenia very closely," said Dr. Druzin, professor of ob.gyn. and chief of maternal and fetal medicine at Stanford (Calif.) University.

The review of all pregnancies complicated by systemic lupus erythematosus seen at the university from 1991 to 2001 covered 63 pregnancies in 48 patients with a mean maternal age of 30 years. Lupus had been present for a mean of 4 years, and the disease was active at conception in 63% of pregnancies. As a group, these were sicker patients than those usually seen by an ob.gyn.

Preeclampsia occurred in 22% of pregnancies. Thrombocytopenia at conception predicted the development of preeclampsia, according to multivariate analyses to identify clinical predictors of prematurity and preeclampsia.

Gestational diabetes occurred in 5% of pregnancies, 4% developed hemolysis, elevated liver, low platelet (HELLP) syndrome. In pregnancies with active maternal lupus at conception, treatments included prednisone (48%), hydroxychloroquine (21%), and antihypertensives (13%).

Maternal antiphospholipid antibodies were detected in about half of all pregnancies. The cohort had a higher likelihood of having ...