Outcomes of Pregnancies Complicated by Systemic Lupus Erythematosus (SLE)
Podjanee Phadungkiatwattana MD*, Pannee Sirivatanapa MD*, Theera Tongsong MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : To assess the outcomes of pregnancies complicated by systemic lupus erythematosus (SLE) and
evaluate the clinical course of the disease during pregnancy.
Materials and Methods : The database of high-risk pregnancies between 1995 and 2006 was prospectively
collected and searched for pregnancies with SLE. The medical records were reviewed.
Results : Sixty-eight pregnant women were identified during the period of the present study. Of 61 (89.7%) live
births, 27 (39.7%) had preterm delivery and 20 (29.4%) had fetal growth restriction. Mean gestational age
was 35.6 + 4.2 weeks. Mean neonatal birth weight was 2322 + 781 grams. There were seven (10.3%) perinatal
deaths. Maternal SLE flares occurred in 20 (29.4%), seven in the first trimester, eight in the second trimester,
five in the third trimester, and none in the post partum period. Preeclampsia is the most common maternal
complication (20.6%). There was a higher rate of flares if the pregnancy occurred while the disease was
active. The predictor of poor pregnancies outcomes included flare-up of the disease, renal involvement,
hypertension, and conception while the disease is active.
Conclusion : Active SLE prior to pregnancy is associated with a less favorable maternal and fetal outcome.
Hypertension increased the risk of fetal loss and adverse outcome.
Keywords : Systemic lupus erythematosus, Pregnancy, Outcome
