title: Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea.
abstract: OBJECTIVE
  To evaluates the pregnancy outcomes in systemic lupus erythematosus (SLE) patients in South Korea and determine the predictive factors for adverse fetal and maternal outcomes.
  
  
  METHODS
  All pregnancies in SLE patients who were seen at the Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. SLE flares were determined by the Lupus Activity Index-Pregnancy (LAI-P) score.
  
  
  RESULTS
  Sixty-two pregnancies were observed in 50 patients. Fifty-one (82.3%) live births and 11 (17.7%) fetal losses were observed. Thirty-eight of the live births (74.5%) were full-term and 13 (25.5%) were preterm births. Fetal losses included three spontaneous abortions, two stillbirths and six therapeutic abortions. Proteinuria during pregnancy was a predictive factor for adverse fetal outcomes (adjusted odds ratio [OR] 12.50; P = 0.032). An LAI-P score was obtained in 36 pregnancies, and SLE flares occurred in 12 pregnancies (33.3%), primarily during the second trimester (46.2%). Renal involvement (69.2%) was the most common SLE flare during pregnancy. All flares were classified as severe flare according to LAI-P scores. SLE flares during pregnancy were strongly affected by proteinuria prior to pregnancy (adjusted OR 30.28; P = 0.024) and the presence of antiphospholipid antibodies (adjusted OR 6.62; P = 0.047).
  
  
  CONCLUSIONS
  Our study demonstrated a rate of live births and of flares in pregnant lupus patients comparable to recent reports in Western countries. Proteinuria during and prior to pregnancy and presence of antiphospholipid antibodies were predictive factors for poor pregnancy outcome. Preserved renal function prior to pregnancy resulted in favorable outcomes even in patients with a history of lupus nephritis.
authors.affiliation: Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Park
authors.forename: Hyemin
authors.initials: H
authors.lastname: Jung
authors.forename: Jiwon
authors.initials: J
authors.lastname: Hwang
authors.forename: Hyungjin
authors.initials: H
authors.lastname: Kim
authors.forename: Jaejoon
authors.initials: J
authors.lastname: Lee
authors.forename: Joong Kyong
authors.initials: JK
authors.lastname: Ahn
authors.forename: Hoon-Suk
authors.initials: HS
authors.lastname: Cha
authors.forename: Eun-Mi
authors.initials: EM
authors.lastname: Koh
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D005260:Female; D006801:Humans; D050498:Live Birth / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D056910:Republic of Korea; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology; D055815:Young Adult
keywords: outcome; pregnancy; systemic lupus erythematosus