Background and aims Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease which commonly affects women of childbearing age. There were reports of the adverse pregnancy outcome in SLE patients but data from Indonesia was still lacking. The objectives of this study were to analyse the outcome of pregnancy in SLE patients and to identify the factors associated with pregnancy outcome.
Methods This was a retrospective study of pregnant SLE patients in Indonesian national referral hospital from 2012–2015. Medical records of all pregnant SLE patients who gave birth in our centre during that period were reviewed. Independent variables were previous and current nephritis, history of adverse pregnancy outcome, pre-pregnancy hypertension, and disease control during pregnancy. Dependent variables were maternal complications (ICU admission, SLE flare, hypertension/eclampsia/preeclampsia, and death) and fetal/neonatal complications (low birth weight, oligohydramnios, and abortion/fetal death/neonatal death).
Results There were 32 pregnancies of which 13 were first pregnancies. Preterm deliveries were observed in 37.5% patients and 66.7% patients were delivered by C-section. Eight patients (25%) experienced maternal complications with 1 patient died due to heart failure. There were 71.9% pregnancies with fetal/neonatal complications and among those, low birth weight was the main complication (39.1%). There were significant association between disease control during pregnancy and maternal complications (p=0.029) and between history of adverse pregnancy outcome and fetal/neonatal complications (p=0.005).
Conclusions The rate of maternal and fetal/neonatal complications was high. Pregnant SLE patients need to be monitored closely especially those with uncontrolled disease during pregnancy and history of adverse pregnancy outcome.
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