Background Systemic lupus erythematosus (SLE),APL, SSc, RA, affects women of child bearing age and is associated with several negative outcomes in pregnancy that includes preterm births, hypertensive disorders and increased risk for Cesarean delivery

Methods This was a retrospective descriptive cross-sectional study based on data from the patients’ records. The study was conducted at KNH. The study involved a cohort of women managed for rheumatic disease (SLE, APL, rheumatoid arthritis, and scleroderma) in pregnancy at KNH, 2010–2022. The targeted sample size was 41, but only 30 patients met the criteria for inclusion in this study.

Results Records of 1200 women with rheumatic diseases seen between 2010 and October 2022 were retrieved. Only 30 patients met the eligibility criteria. The mean maternal age was M = 31.7 years. Prevalence of the rheuatic diseases were as follows: SLE at 63.33% (N = 19), APL, 26.67% (N = 8), RA 20.0% (N = 6), mixed connective tissue disease (MCTD) 6.67% (N = 2) and SSc 3.33% (N = 1).

Maternal outcomes were as follows: post-delivery admission (70.0%, N = 21); pre-eclampsia with severe features (50.0%, N = 15); pre-delivery admissions (46.7%, N = 14) and flaring in (36.7%, N = 11), CS delivery 40.0% (N = 12), premature rupture of membranes 26.7% (N = 8), ICU admissions 23.3% (N = 7), and post-partum hemorrahge20.0% (N = 6).

The main adverse perinatal outcomes noted included fetal loss (including stillbirth) 46.7%, (N = 14), prematurity 23.3% (N = 7), fetal growth restriction 20.0% (N = 6), and new born critical care admission 16.7% (N = 5).

Conclusions The study established that SLE, antiphospholipid and rheumatoid arthritis are the main three rheumatic diseases among pregnant mothers managed with RDs at the KNH. There is significant pregnant morbidity in these patients.