[Systemic lupus erythematosus and pregnancy].
BACKGROUND
Systemic lupus erythematosus (SLE) often starts in women of fertile age. Due to the unpredictable nature of the disease and the increased risk of the disease flaring up during pregnancy, women with SLE have previously often been advised to avoid pregnancy. This summary reviews current insights in pregnancy management of women with SLE.


METHODS
Search in the Medline database (period 1980-2005) using keywords: SLE, lupus nephritis, antiphospholipid antibody, neonatal lupus and pregnancy.


RESULTS
Previous studies of pregnant women with SLE have had different designs, sample sizes, selections of patients, definitions and measures of outcome. Women with previous pregnancy losses, an ongoing active disease with nephritis or hypertension and positive antiphospholipid antibodies, have an increased risk of pregnancy loss. The most favourable pregnancy outcomes are achieved when conception takes place during a remission of the disease.


CONCLUSIONS
There are few absolute contraindications for pregnancies in women with SLE. Women with SLE may experience uncomplicated pregnancies, but they need to plan their pregnancies as the risk for complications is increased. Best results are achieved through the cooperation of rheumatologists, gynaecologists and nephrologists. Glucocorticosteroids, hydroxychlorocine, azathioprine and anticoagulation may be used during pregnancy.
Skomsvoll
Johan Fredrik
JF
Klinikk for ortopedi og revmatologi, Revmatologisk avdeling St. Olavs Hospital, Olav Kyrres gate 17, 7006 Trondheim. johan.skomsvoll@ntnu.no
Aasarød
Knut
K
Salvesen
Kjell A
KA
Hoff
Mari
M
Wallenius
Marianne
M
Rødevand
Erik
E
Koksvik
Hege Suorza Svean
HS
Gilboe
Inge-Margrethe
IM
Nossent
Hans C
HC
D017152:Antibodies, Antiphospholipid / Q000032:analysis; D005260:Female; D005323:Fetal Monitoring; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000151:congenital / Q000276:immunology; D008181:Lupus Nephritis / Q000150:complications / Q000276:immunology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000276:immunology; D011256:Pregnancy Outcome; D012307:Risk Factors
D017152:Antibodies, Antiphospholipid