[Problems posed by pregnancy in women with lupus nephropathy]

The influence of lupus nephropathy on pregnancy and reciprocally was retrospectively studied in a series of 131 pregnancies observed from 1962 to 1981 in 45 systemic lupus erythematosis (SLE) women with renal involvement. Renal biopsy showed proliferative lupus glomerulonephritis in 27. The incidence of live births, corrected for induced abortions, was 87% in 89 pregnancies started before, and 89% in 32 started after the clinical onset of SLE; it was only 63% in 10 cases where lupus nephritis developed during gestation. Relapse or exacerbation of disease activity occurred in 15 (47%) of 32 pregnancies antedated by the onset of SLE, with irreversible renal failure in two cases. Clinical exacerbation of SLE was observed in 13 (76%) of 17 cases where SLE was clinically active at the time of conception, and in only 2 of 15 cases where lupus nephritis was in stable clinical remission for at least 5 months prior to conception. Our data suggest that a successful outcome of pregnancy, without SLE exacerbation, may be expected, even in the more severe forms of lupus nephritis, when gestation begins after a sustained, complete clinical remission.