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[Pregnancy and systemic lupus erythematosus]

I Moga Sampere1, F Formiga Pérez, R Canet González

  • 1Servicio de Medicina Interna, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona.

Medicina Clinica
|October 30, 1993
PubMed
Summary

Pregnancy in women with systemic lupus erythematosus (SLE) can lead to complications, but specific antibodies like antiphospholipid (APL), anti-Ro, and anti-La do not appear to alter pregnancy outcomes. Close monitoring during and after pregnancy is recommended for SLE patients.

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Area of Science:

  • Rheumatology
  • Obstetrics
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) and pregnancy interactions are complex and debated.
  • Patients with SLE may have antiphospholipid antibodies (APL), anti-Ro (a-Ro), or anti-La (a-La), whose effects on pregnancy are not well-defined.

Purpose of the Study:

  • To analyze pregnancy outcomes in women with SLE.
  • To investigate the influence of APL, a-Ro, and a-La antibodies on pregnancy course in SLE patients.
  • To compare disease flares during pregnancy in SLE patients versus a control group.

Main Methods:

  • Studied 96 women with SLE of reproductive age from 1975-1991 with a mean follow-up of 6.2 years.
  • Analyzed spontaneous/provoked abortions, prematurity, and disease flares during pregnancy and postpartum.

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  • Compared flare rates in pregnant SLE patients to a control group with similar clinical features.

    • Main Results:

    • 35 pregnancies in 27 SLE patients resulted in 23 full-term births, 5 spontaneous abortions, and 7 provoked abortions.
    • 26% of deliveries were premature; 43% of pregnancies with viable fetuses experienced 1-2 disease flares.
    • No statistically significant difference in flare rates between the SLE pregnancy group and controls (43% vs. 6%, p=0.55).
    • No correlation found between APL, a-Ro, or a-La antibodies and pregnancy course; no cases of lupus neonatorum observed.

    Conclusions:

    • Pregnancy is not recommended for SLE patients in remission.
    • Increased monitoring during pregnancy and postpartum is crucial for SLE patients.
    • Antiphospholipid antibodies and anti-Ro antibodies do not appear to modify pregnancy prognosis in SLE.