Pregnancy in women with systemic lupus erythematosus (SLE)

• Today, pregnancy is no longer considered impossible in women with lupus.
• Although decreasing over time, fetal loss continues to be more frequent in SLE.
• Severe flares are infrequent in women with inactive SLE and lupus nephritis.
• Antiphospholipid antibodies increase maternal and fetal complications.
• Preconception counseling and pregnancy planning improve pregnancy outcome.

For many years pregnancy has been contraindicated in patients with SLE, particularly when kidney involvement was present. Today, pregnancy is no longer considered impossible in women with lupus. Yet, lupus pregnancies are still considered high-risk. The prognosis has considerably improved for pregnant women but the fetal risk, although progressively reduced, is still higher in pregnancies of patients with SLE than in pregnancies of healthy women. Miscarriage, premature delivery, and preeclampsia, as well as heart problems in the baby are the major complications that can occur.In this paper we will review the outcome of pregnant women with SLE, the influence of lupus on fetal outcome, the effects of pregnancy on lupus, and the management of pregnant lupus patients based on our personal experience and the revision of the most recent and significant papers on the subject.