Evidence map›Paper›PMID 40133904›Full record

ArticleBMC pregnancy and childbirth2025

Pregnancy outcomes and risk factors for thrombocytopenia in pregnant patients with systemic lupus erythematosus.

Qing-Ying Fang, De-Hai Gan, Jia Huang, Fan Lian

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Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Qing-Ying FangDepartment of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, P.R. China.
De-Hai GanReproductive Medicine Center, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, P.R. China.
Jia HuangReproductive Medicine Center, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, P.R. China. hjia@mail.sysu.edu.cn.
Fan LianDepartment of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, P.R. China. lianfan@mail.sysu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo compare pregnancy outcomes between systemic lupus erythematosus (SLE) patients with thrombocytopenia and those without, and to develop a nomogram for assessing the risk of developing SLE-related thrombocytopenia during pregnancy.

methodsClinical data from 178 pregnant patients with SLE were analyzed. Patients were classified into thrombocytopenia and normal platelet groups using a platelet count cutoff of < 100 × 10^9/L. Pregnancy outcomes were compared between these groups. A nomogram was developed to identify factors associated with thrombocytopenia based on univariate and multivariable logistic regression analyses. The performance of the nomogram was assessed through receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).

resultsAmong the 178 patients, 34 were in the thrombocytopenia group and 144 in the normal platelet group. SLE patients with thrombocytopenia had a significantly higher rate of active disease (55.9% vs. 5.6%, P < 0.001) and a higher SLE-Pregnancy Disease Activity Index (SLEPDAI) (4.71 ± 3.04 vs. 2.29 ± 1.88, P < 0.001). When comparing patients with thrombocytopenia (categorized by platelet counts < 50 × 10^9/L and > 50 × 10^9/L) to the control group, the incidence of severe preeclampsia (20.00% vs. 15.79% vs. 4.86%, P = 0.027) and postpartum hemorrhage (26.32% vs. 6.67% vs. 3.47%, P = 0.007) was also significantly higher in the thrombocytopenia group. This group exhibited elevated rates of pregnancy loss (73.33% vs. 31.58% vs. 4.17%, P < 0.001) and stillbirth (20.00% vs. 15.79% vs. 0.69%, P < 0.001). Active disease, previous abortion, and anti-β2GPI antibodies positivity were identified as independent factors of developing SLE-related thrombocytopenia during pregnancy. The area under the curve for the nomogram was 0.833 (95% CI: 0.753-0.913). Both the calibration curve and DCA indicated that the model performed well.

conclusionThrombocytopenia in pregnant patients with SLE is associated with increased disease activity and a higher incidence of adverse outcomes, including pregnancy loss and stillbirth. The nomogram for developing thrombocytopenia during pregnancy may help clinicians improve the management of this group of patients. CLINICAL TRIAL NUMBER: not applicable.

Indexed as

Lupus Erythematosus, SystemicPregnancy ComplicationsPregnancy Complications, HematologicPregnancy OutcomeThrombocytopeniaAbortion, SpontaneousAdultFemaleHumansNomogramsPlatelet CountPre-EclampsiaPregnancyRetrospective StudiesRisk FactorsROC CurveNomogramPregnancySystemic lupus erythematosusThrombocytopenia

Identifiers

PMID40133904
PMCPMC11934599

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