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Related Experiment Videos

Pregnancy in lupus.

C Meng1, M Lockshin

  • 1Division of Rheumatology, Hospital for Special Surgery, New York, New York 10021, USA. Mengc@hss.edu

Current Opinion in Rheumatology
|September 30, 1999
PubMed
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Systemic lupus erythematosus (SLE) patients with established disease face poorer pregnancy outcomes. Active lupus nephritis and hypertension predict fetal loss and premature birth, respectively, impacting maternal and fetal health.

Area of Science:

  • Obstetrics and Gynecology
  • Rheumatology
  • Immunology

Background:

  • Established systemic lupus erythematosus (SLE) is linked to adverse pregnancy outcomes compared to late-onset disease.
  • Active lupus nephritis and maternal hypertension are significant predictors of fetal loss and premature birth, respectively.
  • Placental pathology in SLE and antiphospholipid syndrome (APLS) includes decidual vasculopathy and infarction.

Purpose of the Study:

  • To review pregnancy outcomes in patients with established SLE and APLS.
  • To highlight risk factors for fetal loss, premature birth, and congenital heart block.
  • To discuss diagnostic roles of antibodies and potential treatments in APLS.

Main Methods:

  • Review of existing literature on pregnancy outcomes in SLE and APLS.

Related Experiment Videos

  • Analysis of risk factors including maternal disease activity and autoantibodies.
  • Discussion of placental pathology and neonatal outcomes.

    • Main Results:

    • Established SLE impacts pregnancy outcomes negatively; active renal disease and hypertension are key predictors.
    • Maternal anti-52 kDa SSA/Ro antibodies are a significant risk factor for congenital heart block (12-16% recurrence).
    • Anti-beta-2 glycoprotein I (anti-B2GP-I) antibodies are crucial for APLS diagnosis, especially with negative traditional tests. IVIG may improve birth rates in recurrent miscarriage cases.

    Conclusions:

    • Established SLE and APLS present significant risks during pregnancy requiring careful management.
    • Congenital heart block is a serious risk associated with maternal autoantibodies, with high childhood morbidity.
    • Diagnostic advancements and therapeutic interventions like IVIG offer improved outcomes for specific patient groups.