[Systemic lupus erythematosus and pregnancy. Clinical experience in 57 patients]

We reviewed the obstetric history of 57 patients with systemic lupus erythematosus (SLE). The number and outcome of pregnancies before and after the diagnosis of SLE was recorded. The clinical course of 21 patients who became pregnant during the observation period was noted. Before the diagnosis of SLE, 158 pregnancies resulted in a 20% rate of fetal loss (abortion, pre and neonatal death). This was lower than a 35% rate of fetal loss during pregnancies developed after the diagnosis of SLE. Both rates are significantly higher than the 10% which is considered normal for our reference population (p less than 0.001). A higher rate of fetal loss was observed in active SLE (37%) compared to inactive SLE (19%) and in the presence of SLE nephropathy (34%) than in its absence (17%), (p less than 0,01). A flourishing of SLE was observed in 50% of pregnancies, especially during the first trimester (59%) and after delivery (35%). We conclude that pregnancy occurs frequently in patients with SLE. The fetal risk is high although the clinical course of the disease is usually benign. Results in both terms are unfavourably influenced by the activity of SLE and the presence of nephropathy.