title: Predictors of poor obstetric outcome in women with systemic lupus erythematosus: a 10-year experience of a university hospital.
abstract: OBJECTIVE
  To compare the maternal and fetal outcome in patients with systemic lupus erythematosus (SLE) by a retrospective analysis from 2005 to 2010, and a prospective follow-up of pregnant SLE patients from 2010 to 2015 to find out predictors of poor obstetric outcome.
  
  
  METHODS
  The study included 236 SLE pregnant females (retrospective group) whose data were viewed retrospectively from their medical records, and 214 SLE pregnant females (prospective group) who were followed prospectively to record their maternal and fetal outcome.
  
  
  RESULTS
  There was a highly significant difference between the two groups regarding abortion, venous thromboembolism, prematurity, and intrauterine fetal death (p < 0.001) with more occurrence in retrospective group. Also, the frequency of lupus flares, worsening of renal functions, blood transfusion, maternal mortality, admission to NICU, and neonatal death was higher in the retrospective group (p < 0.05). Predictors of poor obstetric outcome included Last flare before pregnancy <6 months, number of antenatal hospital admissions ≥ 6, use of immunosuppressive therapy, the presence of anti-SSA/Ro and anti-SSB/La, and SLE with nephritis (p < 0.05).
  
  
  CONCLUSIONS
  Improved maternal and fetal outcome in women with SLE has occurred following integrated multidisciplinary approach. This emphasizes the importance of postponing pregnancy when predictors of poor outcome are encountered.
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rezk
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: Hamid
authors.initials: H
authors.lastname: Ellakwa
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: Alaa
authors.initials: A
authors.lastname: Al-Halaby
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: Abdelhamid
authors.initials: A
authors.lastname: Shaheen
authors.affiliation: b Department of Internal Medicine and.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Zahran
authors.affiliation: c Department of Pediatrics , Faculty of Medicine, Menoufia University , Menoufia , Egypt.
authors.forename: Hassan
authors.initials: H
authors.lastname: Badr
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000401:mortality / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000401:mortality / Q000628:therapy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011295:Prenatal Care / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Systemic lupus erythematosus; fetal outcome; maternal outcome