Pregnancy and lupus nephritis in developing countries: A systematic review

Area of Science:

• Nephrology
• Rheumatology
• Obstetrics
• Public Health

Background:

• Systemic lupus erythematosus (SLE) and lupus nephritis (LN) significantly impact pregnancy, affecting maternal and fetal health.
• LN during pregnancy elevates risks of SLE flares, acute kidney injury, preeclampsia, and maternal mortality.
• Fetal risks include intrauterine growth retardation, premature delivery, and fetal loss.

Purpose of the Study:

• To review pregnancy outcomes in patients with SLE and LN in developing countries.
• To identify associations between disease activity, LN, and pregnancy outcomes in low-resource settings.

Main Methods:

• Systematic literature search of PubMed and Google Scholar for studies from 1999-2016 in developing countries.
• Inclusion of 12 studies after review.
• Independent review of all included studies.

Main Results:

• High rates of LN flares correlated with increased SLE disease flares.
• Active SLE at conception was linked to lower live birth rates and higher fetal loss rates.
• Indian studies showed lower live birth rates, higher active disease at conception, but lower preeclampsia rates compared to other Asian studies.

Conclusions:

• Active SLE and LN during pregnancy are associated with adverse fetal outcomes, but management can improve results.
• Effective management strategies are crucial for better pregnancy outcomes in low-resource settings.
• Further research is needed to clarify the complex relationships between disease activity, LN, and pregnancy outcomes in developing nations.