title: Clinical outcomes and predictors of fetal and maternal consequences of pregnancy in lupus nephritis patients.
abstract: OBJECTIVE
  To define the outcomes and risk predictors of fetal and maternal consequences of pregnancy in lupus nephritis (LN) patients.
  
  
  METHODS
  Maternal and fetal outcomes of pregnancy in 52 systemic lupus erythematosus (SLE) patients were observed. Patients were allocated into two groups according to the presence or absence of LN.
  
  
  RESULTS
  LN patients were subject to a higher risk of fetal complications, including fetal loss (7/24, 29.2 %, P = 0.001), lower birth weight (2548.2 ± 540.8 vs. 2949.1 ± 592.6 g, P = 0.028) and a higher frequency of small for gestational age births (33.3 vs. 10.7 %, P = 0.002). Higher rates of lupus flares (83.3 vs. 21.4 %, P = 0.001) and increased LAI-P scores (0.65 ± 0.36 vs. 0.21 ± 0.27, P = 0.001) during pregnancy were observed in LN patients. Multivariate analysis showed that increased SLE activity (P = 0.02, OR 4.2, 95 % CI 1.2-14.5), renal damage (P = 0.001, OR 8.4, 95 % CI 2.2-31.8), hypocomplementemia (P = 0.05, OR 3.23, 95 % CI 1.0-10.7), hypoalbuminemia (P = 0.011, OR 5.62, 95 % CI 1.4-23.0) and hypertension (P = 0.021, OR 6.0, 95 % CI 1.5-24.2) during pregnancy were predictors of adverse fetal outcomes.
  
  
  CONCLUSIONS
  Pregnancy in LN patients should be monitored before and during pregnancy because of poor fetal and maternal outcomes. Increased LAI-P scores, renal damage, hypocomplementemia, hypoalbuminemia and hypertension are predictors of adverse fetal outcomes for SLE patients.
authors.affiliation: Department of Nephrology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, No. 168 Li Tang Rd., Dongxiaokou Town, Tiantongyuan Area, Changping District, Beijing, 102218, China.
authors.forename: Jiaxuan
authors.initials: J
authors.lastname: Lv
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Yuehong
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D008181:Lupus Nephritis / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors