Complicaciones obstétricas en pacientes con lupus eritematoso sistémico de 20 a 35 años atendidas Hospital de Especialidades Teodoro Maldonado Carbo en el periodo 2021-2023.

Abstract

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that affects multiple body systems and increases complications in pregnancy, such as preterm delivery, preeclampsia and fetal death. In Ecuador there are no specific registries on pregnant women with SLE, unlike other countries in the region. The prognosis improves if the disease is controlled before pregnancy, and constant monitoring is essential in high-risk centers, since mortality in these cases can reach up to 79%. The aim of this study was to identify obstetric complications in patients with SLE treated at the Teodoro Maldonado Carbo Hospital from 2021 to 2023. Methodology: This descriptive, cross-sectional, observational study, with retrospective data collection, used medical records and gynecology databases. Data were extracted from the AS400 system and stored in Microsoft Excel. Analysis was performed with SPSS version 26.0 software, using frequencies, percentages, means and standard deviation, along with the chi-square test for bivariate analysis, with a p-value < 0.05. Results: The study included 142 patients with SLE, the most frequent obstetric complications were miscarriage (50.6%) and preeclampsia (40.4%). Preeclampsia, type 2 diabetes mellitus and chronic kidney disease were significantly associated with increased mortality (p = 0.013, p = 0.001 and p = 0.003, respectively). The most common pathologic antecedents in the study population included arterial hypertension (41.7%) and chronic kidney disease (41.7%). Mortality was higher in patients with these conditions compared to those without. Conclusion: Abortion and preeclampsia stand out as the most common obstetric complications in pregnant women with SLE, which highlights the importance of optimizing clinical management in this population.