Autoimmune activity in pregnant women with systemic lupus erythematosus

Abstract

In recent years, the number of autoimmune diseases has been increasing significantly worldwide, in particular, in people of reproductive age. Pregnancy is a factor in the development or exacerbation of autoimmune diseases. Purpose is to determine the spectrum of antibodies in pregnant women with systemic lupus erythematosus (SLE) depending on the damage of target organs to establish the activity of the autoimmune process, and in the future, to prescribe an adequate treatment, and to determine the prognosis.
Patients and methods. We examined 96 pregnant women with SLE, among whom there were 34 women with antiphospholipid syndrome (APS) and 62 women without APS. In the group of women with SLE without APS, the I degree of activity was observed in 48 pregnant women, II degree — in 14 women. In women with SLE in combination with APS І degree of activity was observed in 22 pregnant women, ІІ degree — in 12 women. The spectrum of autoimmune antibodies was determined according to standard methods in a laboratory with European certification.
Results and conclusions. In 75% of pregnant women with SLE II degree of activity, and in almost 60% of pregnant women with SLE І degree of activity, antibodies to double-stranded DNA (dsDNA) were detected, which are a laboratory marker of SLE and are almost never found in other connective tissue diseases. Target organ lesions are observed in all pregnant women under study, however, a significantly higher percentage of carditis and pneumonitis is recorded in women with SLE II degree of activity. According to our data, there is a direct correlation between the presence of positive antibodies to double-stranded DNA (dsDNA) in high titers and lupus nephritis in pregnant women with SLE II degree of activity. In the group of pregnant women with SLE and APS, using a quantitative method for assessing the risk of thromboembolic complications, an extremely high risk of thrombosis was identified, which necessitates effective thromboprophylaxis.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.