Obstetric Outcomes in Patients with Systemic Lupus Erythematosus

Kim, Wan Uk; Min, Jun Ki; Kwun, Nak Ki; Park, Sung Hwan; Hong, Yeon Sik; Lee, Sang Heon; Cho, Chul Soo; Kim, Ho Youn

Abstract

OBJECTIVE
To analyze the effect of clinical and serological variables of SLE on pregnancy outcome and to analyze the effects of pregnancy on the disease course of SLE.
METHODS
We studied retrospectively about 91 pregnancies in 41 female patients with SLE, who had visted to Kangnam St Mary Hospital from January,1990 to May,1996. We divided the patients into two groups, who had been pregnant before SLE was established versus who were pregnant after SLE had been established. We considered the former as control group. We compared the fetal or maternal outcomes after divided the latter into subgroups according to our purposes such as cases with lupus flare versus without lupus flare, autoantibody (+) cases versus (-) cases, cases with renal disease versus without renal disease.
RESULTS
The rate of fetal loss, prematurity was 19. 7%, 46. 9% respectively in 63 cases of 32 patients who were pregnant after SLE had been estabished. The number of pregnancy loss and premature delivery was higher in pregnancy after SLE was established than before SLE was established. Lupus flare was associated with the positivity of antibody to ds DNA and negativity of antibody to Ro. The frequency of fetal loss was higher in pregnancies of antiphospholipid (+) women than those of antiphospholipid (-) women. Pregnancy with renal involvement was associated with short duration of gestation and small body weight of neonate.
CONCLUSION
Lupus pregnancy remains highly risky from a maternal standpoint in terms of increased lupus activity and from fetal outcome standpoint in terms of fetal loss and preterm birth, especially in the antiphosphospholid positive mother.