The fourth trimester and challenges for the lupus patient

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects persons of reproductive age. While SLE management during pregnancy has been previously studied, the unique challenges of the postpartum period, particularly the first 3 months after delivery, remain underexplored. The postpartum period is a time of significant physiological, social, and psychological change for both the birthing parent and infant. This review aims to summarise the available evidence regarding postpartum SLE flares, thrombosis, breastfeeding, perinatal microbiome, perinatal mood and anxiety disorders, maternal-infant bonding, and social support. Additionally, the review identifies significant knowledge gaps in postpartum SLE care and highlights priorities for future research to improve short-term and long-term outcomes for birthing parents with SLE and their infants.