Download PDF
CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2020; 12(02): 141
DOI: 10.4103/ijmbs.ijmbs_60_20
Letter to Editor

Maternal and fetal outcomes in patients with systemic lupus erythematosus

Mahmood Al-Mendalawi
1   Department of Pediatrics and Child Health, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
› Author Affiliations
› Further Information
Also available at
  Permissions and Reprints

Dear Editor,

In January-March 2020 issue of the Ibnosina Journal of Medicine and Biomedical Sciences, Ahmed et al.[[1]] reported that preexisting hypertension and secondary antiphospholipid syndrome were correlated with an increased risk of pregnancy complications in Libyan pregnant women with systemic lupus erythematosus (SLE).[[1]]

There are a few notable methodological limitations that ought to be considered. In the study methodology, Ahmed et al.[[1]] established that the diagnosis of SLE was based on fulfilling at least four of the 1997 American College of Rheumatology (ACR) criteria.[[2]] It is worth mentioning that the 1997 ACR criteria have numerous limitations, namely equal weighting of features that differ in the clinical relevance, bias toward longer duration and more severe disease, and exclusion of SLE patients from research that do not fulfill the four criteria.[[3]] Hence, a good number of pregnant women with SLE who did not meet the four criteria of the 1997 ACR criteria were expected to be misdiagnosed and could not be enrolled in the study.[[1]] This might consequently seriously influence the study results.

A newer classification criteria for SLE supported jointly by the European League Against Rheumatism and ACR have been proposed utilizing strict methodology with a multidisciplinary input. The newer classification criteria have both higher sensitivity (96.1%) and specificity (93.4%) in comparison with 82.8% sensitivity and 93.4% specificity of the 1997 ACR criteria.[[4]] Consequently, employing the newer diagnostic SLE criteria could have been better in elucidating the adverse outcomes and their likely predictors in SLE pregnant women.

Authors' contributions

Single author.


#

Financial support and sponsorship

Nil.




Publication History

Received: 01 June 2020

Accepted: 02 June 2020

Article published online:
07 July 2022

© 2020. The Libyan Authority of Scientific Research and Technologyand the Libyan Biotechnology Research Center. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License,permitting copying and reproductionso long as the original work is given appropriate credit. Contents may not be used for commercial purposes, oradapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Ahmed AM, Ibkhatra SA, Elbraky FM, Alsaeiti KD. Maternal and fetal outcomes in patients with systemic lupus erythematosus. Ibnosina J Med Biomed Sci 2020;12:33-7.
  • 2 Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.
  • 3 Smith EL, Shmerling RH. The American College of Rheumatology criteria for the classification of systemic lupus erythematosus: Strengths, weaknesses, and opportunities for improvement. Lupus 1999;8:586-95.
  • 4 Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol 2019;71:1400-12.