Outcomes of pregnancies complicated by systemic lupus erythematosus (SLE)
Phadungkiatwattana, P.; Sirivatanapa, P.; Tongsong, T.
Journal of the Medical Association of Thailand 90(10): 1981-1985
2007
ISSN/ISBN: 0125-2208 PMID: 18041412 Document Number: 3032
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, 2 7 (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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