title: Gestational outcomes in patients with neuropsychiatric systemic lupus erythematosus.
abstract: This study analyzed maternal and fetal outcomes of pregnancies of neuropsychiatric systemic lupus erythematosus patients followed in a reference unit. This retrospective cohort study included 26 pregnancies of patients seen between 2011 and 2015 included with history and/or active neuropsychiatric systemic lupus erythematosus among 135 pregnancies. Three patients had active neuropsychiatric systemic lupus erythematosus at conception, but only one remained with neurological activity during gestation, characteristically related to the inadvertent suspension of medications. Twenty six percent of the newborns were small for gestational age and 40% of live births were premature, with no neonatal death or early complications of prematurity. Preeclampsia was diagnosed in nine pregnancies, with two cases of early severe form that resulted in intrauterine fetal death. Patients with neuropsychiatric systemic lupus erythematosus had more prematurity and preeclampsia compared to patients without neuropsychiatric disease. However, when concomitant lupus nephritis was excluded, the gestational results of neuropsychiatric systemic lupus erythematosus patients were more favorable.
authors.affiliation: 1 Department of Obstetrics, State University of Rio de Janeiro, Brazil.
authors.forename: G R
authors.initials: GR
authors.lastname: de Jesus
authors.affiliation: 2 Department of Rheumatology, State University of Rio de Janeiro, Brazil.
authors.forename: B C
authors.initials: BC
authors.lastname: Rodrigues
authors.affiliation: 2 Department of Rheumatology, State University of Rio de Janeiro, Brazil.
authors.forename: M I
authors.initials: MI
authors.lastname: Lacerda
authors.affiliation: 1 Department of Obstetrics, State University of Rio de Janeiro, Brazil.
authors.forename: F C
authors.initials: FC
authors.lastname: Dos Santos
authors.affiliation: 1 Department of Obstetrics, State University of Rio de Janeiro, Brazil.
authors.forename: N R
authors.initials: NR
authors.lastname: de Jesus
authors.affiliation: 2 Department of Rheumatology, State University of Rio de Janeiro, Brazil.
authors.forename: E M
authors.initials: EM
authors.lastname: Klumb
authors.affiliation: 2 Department of Rheumatology, State University of Rio de Janeiro, Brazil.
authors.forename: R A
authors.initials: RA
authors.lastname: Levy
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008181:Lupus Nephritis / Q000453:epidemiology*; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology; D055815:Young Adult
keywords: Neuropsychiatric systemic lupus erythematosus; central nervous system lupus; preeclampsia; pregnancy; preterm birth