title: Pregnancy outcomes in systemic lupus erythematosus with and without previous nephritis.
abstract: OBJECTIVE
  To compare rates and predictors of pregnancy complications in mothers with systemic lupus erythematosus (SLE) with and without previous nephritis (PN).
  
  
  METHODS
  Retrospective analysis of 107 pregnancies in 83 women with SLE diagnosed prepregnancy.
  
  
  RESULTS
  Mothers with PN had higher rates of preterm delivery (< 37/40, 30% vs 11%, p = 0.029) than those without PN. Women with PN had earlier onset of preeclampsia [median 34.5 weeks (IQR 32-37) vs 37.5 weeks (IQR 35-38, p = 0.047)] that was more frequently complicated by preterm delivery (p = 0.02). Risk factors for preeclampsia in women with PN include 10-13 weeks' gestation diastolic blood pressure > 80 mmHg and proteinuria, and prepregnancy estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m(2). In women with PN, midtrimester uterine-artery-Doppler notching had low negative predictive value (47%). After 39 months followup, eGFR was stable in women with or without PN.
  
  
  CONCLUSIONS
  In SLE, preterm deliveries are more frequent and preeclampsia occurs earlier in women with PN, but longterm eGFR is preserved.
authors.affiliation: Consultant Obstetric Physician, St. Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Bramham
authors.forename: Beverley J
authors.initials: BJ
authors.lastname: Hunt
authors.forename: Susan
authors.initials: S
authors.lastname: Bewley
authors.forename: Sarah
authors.initials: S
authors.lastname: Germain
authors.forename: Irene
authors.initials: I
authors.lastname: Calatayud
authors.forename: Munther A
authors.initials: MA
authors.lastname: Khamashta
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelson-Piercy
mesh_terms: D000022:Abortion, Spontaneous / Q000000981:diagnostic imaging / Q000453:epidemiology; D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D008181:Lupus Nephritis / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012189:Retrospective Studies; D014463:Ultrasonography