Analysis Of Pregnancy Outcomes In249Pregnancies In Patients With Systemic Lupus Erythematosus

[Aims]To investigate the outcome of pregnancy complicated with Systemic lupus erythematosus (SLE) and its correlative factors and try to provide the best chance for conception, pregnant monitoring to prevent the deterioration of SLE and pregnancy loss and improve the perinatal quality.[Materials and Methods]Retrospective study, from December,1995to July,2011,249pregnancies in243females with SLE in Ren Ji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine To investigate the outcome of pregnancy complicated with SLE and its correlative factors. Statistical calculations were performed with SPSS version19.0. A p-value<0.05was considered significant.[Results]The mean patient age was28.1±4.2(range20-47, median28). Mean numbers of pregnancies per patient were1.1±1.3(range0-7, median1). The mean gestation age was37.2±2.2weeks (range28+6-41+3).Except for12cases of family planning,185of the237pregnancies occurred in the period of disease remission at the time of conception,33occurred during the pregnancy,35complicated hypertensive disorders during pregnancy.Except for59cases of pregnancy loss, the mean birth weight was2766.4±574.8g. There were58cases(32.2%) preterm deliveries and33cases(18.3%) small for gestational age in this study, Apgar scores1’-9.6±1.4,5’-9.8±0.9.The Active disease at conception, proteinuria>2g/d, the presence of antinuclear antibody (ANA) and the low level of C3were found related to the pregnancy loss. The lupus nephritis, proteinuria>lg/d and the low level of CH50were associated with preterm delivery. The Active disease at conception and the diagnosis of SLE during the pregnancy were associated with IUGR. The Active disease at conception, the lupus nephritis, proteinuria>lg/d and the low level of C3were related to PIH. The presence of RNP, proteinuria>lg/d and the low level of C3were related to less gestational age at delivery. The presence of RNP, proteinuria>lg/d, the low level of complement (CH50, C3and C4) and the lack of aspirin were related to lower neonatal birth weight.[Conclusions] Although pregnancy in women with SLE is more likely to suffer pregnancy loss and flare-up of SLE, it is relatively safe especially when the lupus nephritis doesn’t exist and the pregnancy occurred in the period of disease remission. Therefore, supervision of pregnancy in patients with SLE before and during pregnancy should be conducted by both obstetrician and rheumatologist. The timely and reasonable medication controls the SLE disease and improves the pregnancy outcome.