系统性红斑狼疮合并妊娠子代早产儿42例临床分析

Clinical features of preterm infants born to mothers with systemic lupus erythematosus：a retrospective analysis

摘要:

目的 探讨系统性红斑狼疮（SLE）合并妊娠子代早产儿的临床特点，提高新生儿科医师对这部分早产儿的认识。方法 收集2000年1月至2012年6月间SLE合并妊娠子代早产儿的临床资料进行回顾性分析，并与同期出生的除SLE合并妊娠子代早产儿以外的2 308例早产儿住院期间并发症发生情况进行对比。结果 SLE合并妊娠子代早产儿共42例，女婴比例明显高于男婴，其中确诊新生儿狼疮综合征4例。新生儿感染为SLE合并妊娠子代早产儿最常见并发症（47.62%），其次为小于胎龄儿（28.57%），新生儿呼吸窘迫综合征（26.19%），新生儿窒息和先天性心脏病（均为14.29%），肺出血（4.76%）；与同期收治的2 308例早产儿合并新生儿感染（16.81%）、小于胎龄儿（13.21%）和先天性心脏病（5.16%）的发生率进行比较，差异均有统计学意义（均P<0.05）；其他合并症的发生率在两组早产儿间比较差异均无统计学意义。结论 SLE合并妊娠子代早产儿易合并感染性疾病、小于胎龄儿及先天性心脏病，而呼吸方面并发症与同期其他早产儿相比无显著差异。

Abstract:

Objective To retrospectively characterize clinical features of preterm infants born to mothers with systemic lupus erythematosus (SLE). Methods Clinical data of preterm infants born to mothers with SLE in Peking Union Medical College Hospital over a period of more than 10 years (2000-2012) and preterm babies born to mothers without SLE in the same hospital and during the same time period were collected. Preterm-associated complications in the two groups of babies were comparatively analyzed. Results During the time period studied, 128 women with SLE delivered a total of 134 babies, 86 at full-term and 42 at preterm. Of the 42 preterm infants, 4 were diagnosed with neonatal lupus syndrome. Neonatal infection was the most common complication in preterm infants born to SLE mothers, which occurred in 20 cases (47.62%), followed by small for gestational age (28.57%), neonatal respiratory distress syndrome (26.19%), congenital heart disease (14.29%), and neonatal pulmonary hemorrhage (4.76%). In the same time period, 2 308 preterm babies were born to mothers without SLE. In these preemies, 16.81% experienced neonatal infection, 13.21% were small for gestational age, and 5.16% had congenital heart disease. All these parameters were significantly lower than in preterm babies born to mothers with SLE (P<0.05). Conclusions SLE preterm offspring seem to be more prone to neonatal infection, small for gestational age and at a higher risk of congenital heart disease as compared to preterm babies from women without SLE.