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[Lupus nephritis and pregnancy].

N B Gordovskaia, I E Tareeva, N S Panfilenok

    Terapevticheskii Arkhiv
    |July 20, 2000
    PubMed
    Summary

    Pregnancy in women with lupus nephritis (LN) can lead to exacerbations, especially if the disease is active. However, conception during persistent LN remission allows for a viable birth with careful management, minimizing maternal risk.

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    Area of Science:

    • Nephrology
    • Rheumatology
    • Obstetrics

    Background:

    • Lupus nephritis (LN) is a severe renal complication of systemic lupus erythematosus.
    • Pregnancy in women with autoimmune diseases presents unique challenges for both mother and fetus.
    • Antiphospholipid syndrome (APS) can coexist with LN and impact pregnancy outcomes.

    Purpose of the Study:

    • To assess the impact of pregnancy on the course and prognosis of lupus nephritis.
    • To evaluate fetal outcomes in pregnancies complicated by lupus nephritis.
    • To analyze the influence of antiphospholipid syndrome on pregnancy in LN patients.

    Main Methods:

    • Retrospective analysis of 31 female patients with lupus nephritis.
    • Evaluation of 44 pregnancies in patients with lupus nephritis.
    • Assessment of lupus nephritis activity, pregnancy course, and fetal outcomes.

    Main Results:

    • Favorable pregnancy outcomes are achievable in LN patients with persistent remission at conception.
    • One-third of patients experienced LN exacerbations during pregnancy or postpartum.
    • Active LN during pregnancy significantly worsened the disease course and led to unfavorable fetal outcomes.
    • LN onset during pregnancy or postpartum resulted in particularly severe disease.
    • Antiphospholipid syndrome appeared to have a lesser impact on pregnancy outcomes compared to LN activity.

    Conclusions:

    • Lupus nephritis frequently exacerbates during pregnancy and postpartum.
    • Conception during persistent LN remission, with adequate medical care, enables successful delivery with acceptable maternal risk.
    • Close monitoring and management are crucial for pregnant women with lupus nephritis.

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