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


METHODS
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.


CONCLUSIONS
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.
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Podjaneej@yahoo.com
Podjanee
P
Phadungkiatwattana
Pannee
P
Sirivatanapa
Theera
T
Tongsong
D000328:Adult; D001724:Birth Weight; D019992:Databases as Topic; D005260:Female; D005317:Fetal Growth Retardation; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000503:physiopathology*; D008429:Maternal Welfare; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors