[Systemic lupus erythematosus and pregnancy]

The literature about pregnancies in patients with systemic lupus erythematosus (SLE) was reviewed. Information about 1,164 pregnancies was compiled. Fifty-four per cent of the pregnancies were normal, 15 per cent of the babies were premature, and 29 per cent of the pregnancies resulted in fetal wastage. In a background population of 50,000 women the corresponding figures were 80, 4 and 16 per cent, respectively. The neonatal mortality of babies borne by women with SLE was 2 per cent. About one third of the patients had an exacerbation of their disease, mostly post-partum or during the last trimester of the pregnancy. The risk of a exacerbation for patients with active disease at the time of conception was double that of patients with inactive disease. Therapeutic abortions were followed by improvement as well as deterioration of the disease. Two per cent of the patients died during pregnancy or post-partum. Cardiolipin-antibody may be a marker of fetal wastage and Ro-antibody may be a marker of fetal heart block in babies borne by women with SLE. Pregnancy was previously considered inadvisable in all patients with SLE. During recent years, the attitude to this problem has been less rigid. However the patients should be fully informed about the risk of exacerbation, fetal wastage, and premature delivery and patients with active disease should be advised to postpone pregnancy until a remission has been achieved.