[Pregnancy and systemic lupus erythematosus]

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.
• 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.