Biomarker dalam darah ibu dapat mengidentifikasi wanita hamil dengan lupus yang berisiko rendah untuk hasil yang merugikan--T-REC-komunitas reptil-semarang--KSE-komunitas satwa eksotik--lupus--ibu hamil--berita tentang penyakit lupus

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Biomarker dalam darah ibu dapat mengidentifikasi wanita hamil dengan lupus yang berisiko rendah untuk hasil yang merugikan

Kemampuan untuk mengidentifikasi , stratifikasi  rendah vs  pasien risiko tinggi di awal kehamilan akan berdampak signifikan  terhadap perawatan kehamilan , alokasi sumber daya kesehatan , kata para ahli

Date:

September 29, 2015

Source:

Elsevier Health Sciences

Summary:

Wanita hamil dengan lupus eritematosus sistemik , berada pada risiko yang lebih tinggi untuk hasil kehamilan yang merugikan , termasuk preeklampsia , insufisiensi plasenta , kematian janin , keguguran , dan komplikasi lainnya . Sebuah konsorsium peneliti  melaporkan bahwa pemantauan biomarker angiogenik tertentu dalam darah ibu selama awal kehamilan dapat berhasil memprediksi pasien yang akan memiliki kehamilan normal dan mereka yang berisiko tinggi untuk hasil yang merugikan . Hal ini akan memungkinkan dokter untuk mengidentifikasi , nasihat , dan mengelola pasien risiko tinggi pada tahap awal kehamilan .

........ SLE merupakan penyakit autoimun multisistem yang didominasi mempengaruhi perempuan dan  selama tahun kelahiran  anak mereka  . Pada SLE sistem kekebalan yang biasanya melindungi terhadap infeksi berbalik melawan wanita dan dapat menyebabkan kerusakan pada beberapa organ .....more

Biomarkers in
maternal blood can identify pregnant women with lupus at low risk for adverse
outcomes

Ability to identify, stratify low vs. high risk patients early in pregnancy
would significantly impact prenatal care, allocation of healthcare resources, experts
say

Date:

September 29, 2015

Source:

Elsevier Health Sciences

Summary:

Pregnant women with systemic lupus erythematosus, are at higher risk for
adverse pregnancy outcomes, including preeclampsia, placental insufficiency,
fetal death, miscarriages, and other complications. A consortium of top
researchers reports that monitoring specific angiogenic biomarkers in maternal
blood during early pregnancy can successfully predict patients who will likely
have normal pregnancies and those at high risk for adverse outcomes. This will
enable physicians to identify, counsel, and manage high risk patients at an
early stage of pregnancy.

....................

Pregnant women with systemic lupus erythematosus (SLE), are at higher risk
for adverse pregnancy outcomes, including preeclampsia, placental
insufficiency, fetal death, miscarriages, and other complications. In a study
published in theAmerican Journal of Obstetrics & Gynecology, a
consortium of top researchers funded by NIH/NIAMS report that monitoring
specific angiogenic biomarkers in maternal blood during early pregnancy can
successfully predict patients who will likely have normal pregnancies and those
at high risk for adverse outcomes. This will enable physicians to identify,
counsel, and manage high risk patients at an early stage of pregnancy.

SLE is a multisystem autoimmune disease that predominantly affects women
and presents during their childbearing years. In SLE the immune system that
normally protects against infection turns against the woman and can cause
damage to multiple organs. Another condition, antiphospholipid antibodies
(APL), which can occur in patients with or without SLE, can damage the placenta
and cause arterial and venous thromboses. Both of these conditions, whether
occurring separately or together, can lead to fetal death, miscarriages,
preeclampsia, and/or growth restricted babies.

"Given that over 20% of pregnant women with lupus APL experience
adverse pregnancy outcomes, the ability to identify patients early in
pregnancy, who are destined for poor outcomes, would significantly impact care
of this high risk population," explained lead investigator Jane E. Salmon,
MD, of the Division of Rheumatology, Hospital for Special Surgery, and Weill
Cornell Medical College, New York, NY.

Using data and samples from the PROMISSE Study (Predictors of pRegnancy
Outcome: bioMarker In antiphospholipid antibody Syndrome and Systemic lupus
Erythematosus) investigators found that biomarkers, specifically circulating
angiogenic factors that regulate development of the placenta and influence the
health of blood vessels in the mother, can be assessed early in pregnancy. As
early as 12-15 weeks into pregnancies, changes in these biomarkers can signal
an increased risk for severe complications, including preeclampsia before 34
weeks gestation, fetal or neonatal death, or preterm delivery before 30 weeks,
because of placental insufficiency.

The researchers also found that measuring these biomarkers had a high
negative predictive value, meaning that severe complications could actually be
ruled out in most patients, leading to more appropriate prenatal care and less
anxious patients. "Timely risk stratification of patients is important for
effective clinical care and optimal allocation of healthcare resources,"
commented Dr. Salmon.

The PROMISSE Study is the largest multicenter, multiethnic and multiracial
study to prospectively assess the frequency of adverse pregnancy outcomes. In
this research, 497 pregnant patients with SLE and/or APL were enrolled at
<12 weeks gestation between September 2003 and August 2013 at seven sites,
along with 207 matched healthy controls, and were followed every month of
pregnancy.

Without good predictive monitors for complications, most SLE and APL
patients undergo extensive antenatal evaluation, including serial obstetrical
ultrasound exams and multiple visits to rheumatologists and obstetricians. The
majority of lupus and/or APL women would be identified as being at low risk for
severe adverse outcomes and in this group the number of medical visits could be
substantially reduced. Patients at low risk can be reassured and healthcare
costs for their pregnancies decreased, whereas those at high risk can be
managed by specialists with close monitoring and delivery for severe maternal
and/or fetal disease.

"Pregnancies in patients with SLE and/or APL can result in poor
outcomes, even when disease activity is low, and baseline clinical features and
laboratory tests have only modest ability to identify patients at highest risk
for adverse pregnancy outcomes," noted Dr. Salmon. "Our study is the
first to demonstrate, in a prospective cohort, the usefulness of angiogenic
biomarkers measured as early as the 12th week of pregnancy, in combination with
clinical criteria, to identify patients with SLE and/or APL at risk of severe
adverse pregnancy outcomes."

"A fundamental question of pregnant mothers with lupus or
antiphospholipid antibody syndrome is whether their pregnancy will turn out
fine or they will develop complications of pregnancy. This important study
indicates that if the concentration of biomarkers measured in maternal blood in
early pregnancy is normal, over 95% of the pregnancies will not develop
preeclampsia, fetal growth restriction, or death. Therefore, the simple
measurement of these biomarkers can be highly reassuring to mothers, families,
and physicians," said Roberto Romero, MD, DMedSci, Editor-in-Chief for
Obstetrics of theAmerican Journal of Obstetrics & Gynecology and
Chief of the Perinatology Research Branch of NICHD/NIH.







Story Source:

The above post is reprinted from materials provided byElsevier Health Sciences. Note: Materials
may be edited for content and length.







Journal Reference:

1.   
Jane E. Salmon, MD et al. Angiogenic Factor Imbalance Early in
Pregnancy Predicts Adverse Outcomes in Patients with Lupus and Antiphospholipid
Antib

http://www.sciencedaily.com/releases/2015/09/150929065950.htm

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