Outcomes of pregnancies complicated by systemic lupus erythematosus (SLE)

Podjanee Phadungkiatwattana, Pannee Sirivatanapa, Theera Tongsong
Journal of the Medical Association of Thailand 2007, 90 (10): 1981-5

OBJECTIVE: To assess the outcomes of pregnancies complicated by systemic lupus erythematosus (SLE) and evaluate the clinical course of the disease during pregnancy.

MATERIAL AND METHOD: The database of high-risk pregnancies between 1995 and 2006 was prospectively collected and searched for pregnancies with SLE. The medical records were reviewed

RESULTS: Sixty-eight pregnant women were identified during the period of the present study. Of 61 (89.7%) live births, 27 (39.7%) had preterm delivery and 20 (29.4%) had fetal growth restriction. Mean gestational age was 35.6 +/- 4.2 weeks. Mean neonatal birth weight was 2322 +/- 781 grams. There were seven (10.3%) perinatal deaths. Maternal SLE flares occurred in 20 (29.4%), seven in the first trimester, eight in the second trimester five in the third trimester, and none in the post partum period. Preeclampsia is the most common maternal complication (20.6%). There was a higher rate of flares if the pregnancy occurred while the disease was active. The predictor of poor pregnancies outcomes included flare-up of the disease, renal involvement, hypertension, and conception while the disease is active.

CONCLUSION: Active SLE prior to pregnancy is associated with a less favorable maternal and fetal outcome. Hypertension increased the risk of fetal loss and adverse outcome.

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