Could women with systemic lupus erythematosus (SLE) have successful pregnancy outcomes? Prospective observational study

Aim of the workThe aim of this study was to determine the frequencies and predictors of maternal and fetal pregnancy outcomes in women with systemic lupus erythematosus (SLE).Patients and methodsData of 37 pregnancies of 34 patients with systemic lupus erythematosus were collected prospectively from patients at Rheumatology and Rehabilitation department of Cairo University Hospitals from 2007 to 2009. Univariate analysis and logistic regression analysis were used.ResultsThere were five spontaneous miscarriages, and 32 pregnancies resulting in live births. There were 20 full term babies and 12 preterm babies. Eight fetuses were born with intrauterine growth retardation (IUGR) and seven babies were born with low birth weight (LBW). Six babies were incubated at NICU (premature) with four neonatal deaths. Among 37 pregnancies, 32 women (86.5%) were in clinical remission before pregnancy; only five patients (13.5%) were active. There were 21/32 episodes of SLE flare up (65.6%) during pregnancy and eight postpartum flare up (21.6%). Eight women (21.6%) developed preeclampsia during pregnancy. Planned pregnancy and SLEDAI at the beginning of pregnancy were significantly associated with fetal loss at univariate analysis. However, there were no significant predictors of fetal loss at binary logistic regression analysis. There was no maternal mortality reported. Renal lupus disease was found to be a predictor of pre-eclampsia occurrence in univariate analysis (P = 0.04).ConclusionIn general, pregnancies can be successful in most women with SLE with a favorable fetal outcome. SLE tends to flare during pregnancy. Flares are maximal during the second trimester.