Background Women with Systemic Lupus Erythematosus (SLE) might be more vulnerable to reduce or stop working during pregnancy because of the increased risk of pregnancy complications compared to the general population. Therefore, we aim to assess differences in work participation during pregnancy and thereafter between pregnant women with SLE and matched controls.

Methods A case-control study on employment was performed in pregnant women with SLE and matched controls. Matching criteria were age, year of delivery, and number of living infants. Employment was defined as having ≥8 hours/week of paid work before conception. Interruption or reduction of work for >1 week during pregnancy, complete cessation of work for >1 week until delivery, and the time in weeks to return to work after maternity leave were assessed.

Results A total of 42 women were included (21 SLE patients, 21 matched controls). Mean SELENA-SLEDAI before pregnancy in SLE patients was 2.6 (SD 2.3). Interruption of work for >1 week and/or completely stop working during pregnancy occurred in more women with SLE compared to matched controls (OR=9.0, 95% CI [1.1–71.0], p=0.04) and the duration of sick leave was longer (p=0.004). After delivery, no difference in return to work after maternity leave was found between women with SLE and controls (OR=1.0, 95% CI [0.25–4.0], p=1.0).

Conclusion Pregnant women with SLE more frequently stopped working compared to matched controls. These findings warrant improved counseling of these women as well as extra attention of healthcare providers, including company doctors.