BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disorder which may
be affected by hormonal changes, such as those of pregnancy. Women with SLE have increased
adverse pregnancy outcomes. STUDY DESIGN: A retrospective analysis of the gynecologic
and immunologic case history of 140 women with SLE and the outcome of 263 pregnancies
in 99 women with SLE. RESULTS: In patients diagnosed with SLE, the proportion of pregnancies
ending with live birth at term decreased to one-third compared with three quarters
in those without a diagnosis of SLE and the incidence of pre-term deliveries and spontaneous
abortions increased by 6.8 and 4.7 times, respectively. When SLE was associated with
secondary antiphospholipid (APL) syndrome, and lupus anticoagulant (LA) or beta2-glycoprotein
antibodies were present, a further increase in the incidence of pregnancy loss was
observed. Pregnancy did not cause a flare-up of SLE in all cases, the disease remained
stable in about 30% of the patients. Lupus was mild in the majority of the women who
carried out their pregnancy to term. We also observed mothers with active SLE who
successfully carried out pregnancies to term. CONCLUSION: These findings accord with
previous literature and should inform rheumatologists, obstetricians and neonatologists
who guide patients in their reproductive decisions.
