Class III-IV proliferative lupus nephritis and pregnancy: a study of 42 cases.
OBJECTIVE
A growing number of women with lupus nephritis wish pregnancy. Our aim was to analyze maternal and fetal outcome in pregnancies with the most severe forms (proliferative or class III-IV) of lupus nephritis.


METHODS
Forty-two pregnancies in 35 women with class III or IV lupus nephritis confirmed by renal biopsy (group 1); 12 pregnancies in 10 patients having histologically proven lupus nephritis class II or V (group 2); and 54 pregnant women randomly selected among our cohort of pregnant lupus patients without nephropathy who were matched for age, parity and duration of lupus to patients with class III or IV lupus nephritis (group 3) were studied.


RESULTS
Pregnancy outcome and mean gestational age of neonates were similar in the three groups studied with hypertension and preeclampsia, being significantly more prevalent in patients in group 1 (37.1%) than among patients in groups 2 (11.1%) and 3 (11.6%) (P < 0.05). Mean birthweight (+/-S.D.) was significantly lower in group 1 (2214 +/- 802 g) than in groups 2 (2783 +/- 721 g) and 3 (2870 +/- 835 g) (P < 0.05).


CONCLUSIONS
Lupus nephritis class III-IV is a risk factor for hypertensive disease during pregnancy, but it does not contraindicate gestation.
Carmona
Francisco
F
Institut Clínic of Gynecology, Obstetrics, and Neonatology, Barcelona, Spain.
Font
Josep
J
Moga
Isabel
I
Làzaro
Isabel
I
Cervera
Ricard
R
Pac
Visitación
V
Balasch
Juan
J
D000328:Adult; D001706:Biopsy; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000473:pathology; D008181:Lupus Nephritis / Q000175:diagnosis / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000473:pathology*; D011256:Pregnancy Outcome; D012307:Risk Factors