{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:26:56Z","timestamp":1754162816350,"version":"3.41.2"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Adv Rheumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Systemic lupus erythematosus (SLE) directly impacts pregnancy outcomes, and few studies have analyzed the related risk factors for maternal and fetal\/perinatal complications in Brazil. We described and analyzed the risk factors for maternal and fetal complications in SLE pregnancies at an outpatient clinic in the State of Amazonas, Northern Brazil.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Pregnancies that occurred after the SLE diagnosis between 2001 and 2020 were analyzed. Risk factors for adverse outcomes were determined using logistic regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 155 pregnancies from 109 women were included; the mean age was 28.2 (<jats:inline-formula>\n                <jats:tex-math>$$\\pm$$<\/jats:tex-math>\n              <\/jats:inline-formula>5.5) years, the median disease duration was 72 [36; 108] months, 56 (36.1%) had active disease prior to pregnancy, 39 (26.5%) had nephritis, 30 (20.3%) had cutaneous manifestations, and the incidence of disease activity during pregnancy was 29.7%; there was a 12.3% (95% CI, [4.2; 20.4]) increase in the proportion of patients with active disease, there were 35 (22.9%) fetal deaths, 26 (16.8%) cases of preeclampsia, 44 (37.3%) preterm births, 16 (16.2%) cases of low birth weight for gestational age, and 18 (18.8%) cases of intrauterine growth restriction. Risk factors for maternal events included immunological alterations (OR=3.02; 95% CI [1.11; 8.21]), renal involvement (OR=3.74; 95% CI [1.25; 11.21]), and disease activity before pregnancy (OR=1.30; 95% CI [1.04; 1.64]); the use of hydroxychloroquine before pregnancy was protective (OR=0.23; 95% CI [0.08; 0.67]). Risk factors for fetal events included the use of acetylsalicylic acid (ASA) during pregnancy (OR=5.22; 95% CI [1.33; 20.54]) and disease activity during pregnancy (OR=1.31; 95% CI [1.14; 1.52]); the use of antimalarials before and during pregnancy was protective (OR=0.14; 95% CI [0.04; 0.44]). According to the post-hoc analysis, the probability of a Type S error in the ASA association was 100%. The retrospective nature and the presence of missing data about laboratory tests are the main limitations of this study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Pregnancy management in SLE presents a unique set of challenges that require a comprehensive and multidisciplinary approach. Careful monitoring of disease activity, appropriate medication management, and psychosocial support are essential for optimizing maternal and fetal health outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s42358-025-00467-2","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T15:02:29Z","timestamp":1753714949000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic lupus erythematosus and risk factors for adverse outcomes in pregnancy: a single center retrospective cohort study in Northern Brazil"],"prefix":"10.1186","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0129-0276","authenticated-orcid":false,"given":"S\u00e9rgio Henrique","family":"Oliveira dos Santos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9944-7229","authenticated-orcid":false,"given":"Juliana","family":"B\u00fchring","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1643-0059","authenticated-orcid":false,"given":"Luiz Fernando de","family":"Souza Passos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5922-7766","authenticated-orcid":false,"given":"B\u00e1rbara Seabra","family":"Carneiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-5134","authenticated-orcid":false,"given":"Domingos S\u00e1vio","family":"Nunes de Lima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-8659","authenticated-orcid":false,"given":"Sandra L\u00facia","family":"Euz\u00e9bio Ribeiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"issue":"2","key":"467_CR1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.ajog.2008.03.012","volume":"199","author":"MEB Clowse","year":"2008","unstructured":"Clowse MEB, Jamison M, Myers E, et al. 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