系统性红斑狼疮孕妇孕产次和受孕时机对新生儿的影响

Correlation between outcome of pregnancy andcondition of disease at conception in systemiclupus erythematosus women

将３４例妊娠合并系统性红斑狼疮（ＳＬＥ）孕妇分为初孕组和经孕组，比较其新生儿体重和出生时孕周，并对在疾病的不同状态下（缓解期、控制期、活动期和妊娠时初次发病）受孕后新生儿体重、分娩孕周进行比较。结果表明：初孕组新生儿体重明显高于经孕组，分娩孕周差异无显著性；在疾病活动期受孕，其新生儿体重、分娩孕周最低。提示：ＳＬＥ患者应在疾病缓解期或控制期，即停药后１年或用小剂量强的松（每日５～１５ｍｇ）维持量半年以上时受孕，其ＳＬＥ恶化率低，孕妇及新生儿安全性亦较大。同时应尽可能避免多次受孕，以免给下次妊娠带来不良影响。

Thirty four pregnant patients with systemic lupuserythematosus (SLE) were divided into 3 groups: (1) primigravida, (2) previous history of spon-taneous abortion, and (3) previous history of inducedabortion. Outcomes of theses pregnancies showed thatthe average birth weight in primigravida group wassignificantly higher than that in the other 2 groups(P < 0.05). Grouping by clinical status of SLE at con-ception, there were 4 kinds of situation. (1) remission,(2)controlled, (3) active, and (4)first onset. Patientswith SLE of active stage had the lowest birth weightand gestational age babies (P < 0.05). The best time forconception in SLE women was at the time of remissionor controlled stage, i.e. patients treated withprednisone in a dose of 5～15 mg / day for more than6 months or without any medication for at least 1year.