Abstract
Background and aims Systemic lupus erythematosus (SLE) usually affects women of child-bearing age, with pregnancy thus posing a relevant management challenge. This paper describes materno-fetal outcomes among Filipino SLE patients in a single tertiary care centre.
Methods We retrospectively reviewed the medical files of patients in the Lupus Database of the University of Santo Tomas Hospital in Manila, Philippines, who had a recorded pregnancy after SLE diagnosis, describing the maternal and fetal outcomes of each pregnancy.
Results There were a total of 197 pregnancies among 99 patients. Average age at first pregnancy was 29 years old. Lupus Nephritis (LN) was present in 13.7%, hyperthyroidism 1.0%, and autoimmune thyroiditis 1.0%. Maternal complications intra- and post-partum included hypertension (5.6%), pulmonary tuberculosis (TB) (4.0%), pre-eclampsia (3.6%), HELLP syndrome, gestational diabetes (GDM) (3.0%), urinary tract infections (UTI) (3.0%), herpes zoster (2.0%) and 0.5% cases each of TB meningitis, TB spondylitis, dilated cardiomyopathy, and postpartum depression. Term deliveries were recorded in 98 (79.0%) pregnancies while 26 (21.0%) were delivered preterm. There were 73 (37.0%) nonviable pregnancies including miscarriages (82.2%), intrauterine fetal demise (IUFD) (11.0%) and blighted ovum (6.8%). Normal birth weight was recorded in 83.9% of infants. Congenital abnormalities included congenital heart block (0.8%), meningocoele (0.8%), thyroid abnormality (0.8%), G6PD deficiency (0.8%), and autism (0.8%).
Conclusions Although successful pregnancy outcomes are possible for SLE patients, miscarriages, preterm deliveries, blighted ovum and IUFD remain a concern, requiring close monitoring and intensive multi-specialty team approach.
