Background Systemic lupus erythematosus (SLE) is associated with increased pregnancy complications. In addition, pregnancy may lead to disease exacerbations in SLE. Another problem is infertility and early menopause caused by drugs, like cyclophosphamide.
Objectives In this study, we aimed to evaluate pregnancy complications and menstrual problems in SLE patients.
Methods Out of 400 regularly followed SLE patients, 73 patients with 86 pregnancies during the last 5-year period from 2 centers were included. SLE patients were questioned about the presence of pregnancy, history of menstrual cycle, the method of contraception, status of fertility and exacerbation of SLE during pregnancy. Their medical records were evaluated to retrieve data about the pre-mentioned questions
Results During this period, 10 SLE patients had come to hospital for the treatment of infertility. 7 of them became pregnant by in vitro fertilization. 52 of SLE patients planned pregnancy before conception. Fetal loss developed in 18 patients, 6 patients experienced preeclampsia during pregnancy. Premature delivery developed in 5 patients. The frequency of fetal loss tended to be higher in SLE patients with unplanned pregnancy (38.5 vs. 25%, p>0.05). Fetal loss was significantly higher in anti-phospholipid syndrome group (35% vs. 4.2%, p=0.002) and in SLE patients with hypocomplementemia (47.1% vs. 20.9%, p=0.059).
SLE flares were observed in 15 patients and nephritis (8 patients) was the most common finding of exacerbation. SLE flare group during pregnancy had a significantly higher rate of hypocomplementemia (84.6% vs. 30.8%, p=0.001), premature delivery (27.3% vs. 2.3%, p=0.023), and APS (27.3% vs 7%, p=0.056).
Conclusions In our cohort, fetal loss and SLE flares were relatively higher. APS and hypocomplementemia were associated with fetal loss and disease flares.
Disclosure of Interest None declared
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