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Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

Overview of attention for article published in Therapeutics and Clinical Risk Management, May 2018
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Title
Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis
Published in
Therapeutics and Clinical Risk Management, May 2018
DOI 10.2147/tcrm.s160760
Pubmed ID
Authors

Jiayue Wu, Jinghang Ma, Wei-Hong Zhang, Wen Di

Abstract

Although it is well established that systemic lupus erythematosus (SLE) negatively affects pregnancy outcomes, there is insufficient evidence on the effect of lupus nephritis (LN) on antenatal management and pregnancy outcomes. We performed a systematic review and meta-analysis to determine the association of LN with management and pregnancy outcomes in SLE patients. Embase, Medline, Cochrane, and ClinicalTrials.gov were carefully searched for relevant English and Chinese language studies. A total of 2,987 articles were reviewed. Data were extracted that compared management and pregnancy outcomes in SLE pregnant women with LN vs without LN. Risk of bias was assessed by a modified version of the Newcastle-Ottawa Scale and the STROBE checklist. Combined odds ratios (OR) and 95% confidence intervals (CI) were obtained and sensitivity analysis was performed using RevMan 5.3 software. Sixteen studies, including 1,760 pregnant patients with SLE, were included. Gestational hypertension (OR=5.65, 95% CI=2.94-10.84), preeclampsia (OR=2.84, 95% CI=1.87-4.30), SLE flare (OR=2.66, 95% CI=1.51-4.70), renal flare (OR=15.18, 95% CI=5.89-39.14), proteinuria (OR=8.86, 95% CI=4.75-16.52), and hypocomplementemia (OR=2.86, 95% CI=1.68-4.87) were significantly affected in pregnant women with LN. Anti-Sjögren's syndrome-related antigen A/Ro autoantibodies were negatively associated with pregnant women with LN (OR=0.57, 95% CI=0.33-0.98). Pregnant women with LN presented a significant decrease in live births (OR=0.62, 95% CI=0.49-0.80) and a significant increase in preterm births (OR=1.92, 95% CI=1.49-2.49) and fetal growth restriction (OR=1.43, 95% CI=1.08-1.91). Regarding antenatal management, steroids (OR=2.48, 95% CI=1.59-3.87) and immunosuppressant treatment (OR=6.77, 95% CI=3.30-13.89) were more frequently used in women with LN. This review identified a significant association between the aforementioned outcomes and SLE pregnant patients with LN. In patients with SLE, LN increased the risks for adverse pregnancy outcomes and the use of medication. Therefore, special treatment and close monitoring should be allocated to pregnant women with LN.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 93 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 93 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 13 14%
Student > Master 11 12%
Student > Ph. D. Student 8 9%
Other 7 8%
Researcher 6 6%
Other 14 15%
Unknown 34 37%
Readers by discipline Count As %
Medicine and Dentistry 42 45%
Nursing and Health Professions 4 4%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Immunology and Microbiology 2 2%
Psychology 2 2%
Other 6 6%
Unknown 35 38%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 May 2018.
All research outputs
#20,663,600
of 25,382,440 outputs
Outputs from Therapeutics and Clinical Risk Management
#1,070
of 1,323 outputs
Outputs of similar age
#264,938
of 339,234 outputs
Outputs of similar age from Therapeutics and Clinical Risk Management
#27
of 32 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one is in the 10th percentile – i.e., 10% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,323 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 9th percentile – i.e., 9% of its peers scored the same or lower than it.
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We're also able to compare this research output to 32 others from the same source and published within six weeks on either side of this one. This one is in the 9th percentile – i.e., 9% of its contemporaries scored the same or lower than it.