Hypertension as a risk factor in pregnancies complicated by systemic lupus erythematosus

To study the occurrence and significance of pregnancy-associated hypertension and pre-eclampsia in systemic lupus erythematosus (SLE), we studied retrospectively 34 pregnancies in 27 SLE patients in 1981-87. Eleven pregnancies (32%) were hypertensive (group A). The remaining 18 patients during their 23 pregnancies had a normal blood pressure (group B). Previous nephritis was slightly more common in the hypertensive group (54.5% vs. 26.1%, NS). Preeclampsia was present in seven of the pregnancies (21%) and of whom four were superimposed. Flare-ups of the disease were more common in the non-hypertensive group (30.4%) than in group A (9.1%) (NS). Duration of pregnancy was the same in the two groups. Intra-uterine growth retardation was present in 27.3% of the pregnancies in group A and in 13.0% of group B (NS). Fetal loss occurred only in 2 patients of the non-hypertensive group; one patient had exacerbation of SLE and the other (with two stillbirths) high anticardiolipin antibodies. Our data suggest that pregnancy-associated hypertension and pre-eclampsia do not cause increased fetal loss in pregnancies affected by SLE. There seem to be other factors that are more important, such as antiphospholipid antibodies and flare-ups of the disease.