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Because of improved treatment and pregnancy management, many patients with systemic lupus erythematosus (SLE) now have safe, successful pregnancies. Prior studies have led to identified specific risk factors for poor pregnancy outcome, among them antiphospholipid antibody (aPL), severe disease flare and kidney disease. Adverse pregnancy outcomes that still do occur in patients with SLE include fetal death, pre-eclampsia, preterm delivery and small for gestational age infants. Thus many surviving babies are at risk for the later life physical complications and neurodevelopmental delays associated with early gestational age and small size. While numbers vary from study to study, preterm birth and low birth weight probably occur in up to a quarter of SLE pregnancies overall. Risk of damage to their children is an area of concern for women with lupus and for their physicians.
Some have suggested that the risk for neurodevelopmental delay is even greater than the risk imposed by low gestational age and birth size alone. In 1988 …