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Hypocomplementemia correlates with intrauterine growth retardation in systemic lupus erythematosus
N Kobayashi1, H Yamada, T Kishida
1Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
Problem:
The aim of this study was to elucidate fetomaternal risks in systemic lupus erythematosus (SLE)-complicated pregnancy.
Method Of Study:
Pregnancy course, complications, and fetal outcome in 82 pregnancies of 55 patients with SLE were investigated.
Results:
These 82 pregnancies resulted in 14 fetal losses and 66 live births. Without clinical manifestation of SLE-flare, 4 of 8 patients who had low serum complement activity during the pregnancies delivered small-for-date neonates. The rate of the intrauterine growth retardation was significantly higher than that observed in pregnancies with normal complement activity. The frequency of premature deliveries (60%) in patients who received more than 15 mg/day of prednisolone was significantly high when compared with pregnancies maintained by 0-15 mg/day (13.1%).
Conclusions:
These data demonstrate the preconceptional and perinatal management necessary in SLE and suggest that the pregnancy with hypocomplementemia, the disease activity, and/or a relatively high maintenance dose of corticosteroid should be carefully managed and monitored.