Background Systemic lupus erythematosus (SLE) is a chronic disease affecting mainly women in childbearing age. Studies have shown that pregnancy in SLE women puts the mother and the fetus at risk of serious adverse events . The prevalence of these events is under reported in the Arab countries. This study is to examine the pregnancy outcomes in patients with SLE.
Methods We have retrospectively analyzed the medical files, and electronic medical records of all pregnant patients with SLE attended our Rheumatology Clinic between 2007 to 2014. All patients met ACR classification criteria for SLE. We have excluded patients diagnosed with DM, hypertension, chronic kidney disease before the onset of lupus.
We captured the following data: patient demographic number of pregnancies after the onset of SLE, pregnancy outcomes, maternal complications during and after pregnancy.
Results We identified 150 pregnancies in 64 patients with lupus, and 57 (89%) patients were Arabs. The total number of live birth was 105 (70%). An adverse fetal event was observed in 48 (32%) pregnancies. Total number of miscarriages was seen 43 (28.6%), six (4%) were induced abortions. Two died in utero (1%) and there was one neonatal death (1%). 44 (29%) were born below 2,500g, four were premature (less than 37 weeks) (3%), intrauterine growth retardation was observed in 19 (12.6%) and four born with malformation (3%). Obstetric complications occurred in 30 (20%) pregnancies, 5 (3%) had pre-eclampsia, 5 (3%) had gestational diabetes, and one had postpartum hemorrhage (1%). Maternal complications were detected in 20 (13.3%) pregnancies, lupus flare was observed in 18 (12%), five had thrombosis (3%), and no death.
Conclusions Pregnancy in lupus is often associated with an adverse maternal and fetal outcome independent by disease activity.
Josephine Patricia Dhar, and Robert J. Sokol, Lupus and Pregnancy: Complex Yet Manageable. Clin Med Res. 2006; 4(4): 310–321.
Disclosure of Interest None declared