Palabras clave
mortalidad fetal
muerte materna
trabajo de parto prematuro
retardo del crecimiento fetal
Cómo citar
Resumen
Contexto: el lupus eritematoso sistémico (LES) es una enfermedad autoinmune crónica, donde una complicación grave es la nefritis lúpica (NL). En el caso de mujeres embarazadas con NL se identifica un mayor riesgo de complicaciones materno-fetales.
Objetivo: determinar la frecuencia y el riesgo de los principales desenlaces maternos y perinatales en mujeres gestantes con NL en América Latina y el Caribe.
Metodología: revisión sistemática del periodo 2003-2023 en las bases de datos Medline (Pubmed), Embase, Lilacs, Web of Science y Scopus. La selección, extracción y evaluación de la calidad se realizó de forma pareada. Se utilizó el método de efectos aleatorios para evaluar los desenlaces para el metaanálisis y el protocolo fue registrado en el sistema PROSPERO bajo el código CRD42023464651.
Resultados: 12 estudios provenientes de siete países fueron incluidos, principalmente cohortes retrospectivas y un estudio transversal. Se identificaron asociaciones significativas entre la presencia de NL versus sin NL para los desenlaces de mortalidad perinatal (OR?=?2,53; IC 95?% 1,23-5,19) y preeclampsia (OR?=?2,24; IC 95?% 1,43-3,49), pero no significativos para parto prematuro y aborto espontáneo. Solo se identificó un fallecimiento para mortalidad materna y no se evidenciaron hallazgos que implicaran restricción del crecimiento intrauterino (RCIU) ni insuficiencia renal. En cuanto a la evaluación de la calidad, se presentó 1 artículo de baja calidad y 11 de alta calidad.
Conclusiones: se destacó la alta frecuencia de mortalidad perinatal y preeclampsia, aunque no se encontraron asociaciones significativas con mortalidad materna, parto prematuro y aborto espontáneo, ni datos para RCIU o insuficiencia renal. Se requiere mayor investigación para establecer asociaciones entre NL y desenlaces materno-perinatales.
Citas
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