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Pregnancy in systemic lupus erythematosus: a retrospective study from a developing community

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Abstract

Little data exists from the developing world on pregnancy in systemic lupus erythematosus (SLE). A 10-year review of pregnancies in lupus patients was conducted at a tertiary hospital in a developing country. Forty-seven pregnancies in 31 patients were identified. Eleven (23%) booked after 20 weeks gestation. There were no maternal deaths; six (13%) mothers experienced flares—all mild. Twelve women developed preeclampsia of which one experienced an intrauterine death. One patient was diagnosed with lupus and nephritis during pregnancy. She required an abortion to control the disease. Another with active nephritis delivered a normal but premature infant despite cyclophosphamide therapy. There was only minor deterioration in renal function. There were 36 (77%) live births, 8 first trimester abortions, 2 elective abortions and 1 still birth. Fourteen (39%) of live births were premature, and five (14%) experienced intrauterine growth retardation (IUGR). Two live-born babies experienced neonatal heartblock, and one, a neonatal lupus rash. We discuss these finding in relation to risk factors and to results from the developed world.

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References

  1. Merrill JA (1955) Cortisone in disseminated lupus erythematosus during pregnancy. Obstets and Gynaecol 6:637–642

    Article  CAS  Google Scholar 

  2. Fine LG (1981) Systemic lupus erythematosus in pregnancy. Ann Intern Medicine 94:667–677

    Google Scholar 

  3. Petri M (2004) Prospective study of systemic lupus erythematosus pregnancies. Lupus 13:688–689

    Article  PubMed  CAS  Google Scholar 

  4. Carmona F, Font J, Cervera R et al (1999) Obstetrical outcome of pregnancy in patients with systemic lupus erythematosus. A study of 60 cases. Eur J of Obsts Gynecol Reproduct Biol 83:137–142

    Article  CAS  Google Scholar 

  5. Georgiou PE, Politi EN, Katsimbri P et al (2000) Outcome of lupus pregnancy: a controlled study. Rheumatology 39:1014–1019

    Article  PubMed  CAS  Google Scholar 

  6. Le Thi Huong D, Wechsler B, Piette J-C et al (1994) Pregnancy and its outcome in systemic lupus erythematosus. Q J Med 87:721–729

    CAS  Google Scholar 

  7. Aggarwal N, Sawhney H, Vasishta K et al (1999) Pregnancy in patients with systemic lupus Erythematosus. Aust N Z J Obstets and Gynaecol 31:28–30

    Article  Google Scholar 

  8. Tan LK, Tan HK, Lee CT et al (2002) Outcome of pregnancy in Asian women with systemic lupus erythematosus: experience of a single perinatal centre in Singapore. Ann Acad Med Singapore 31:290–295

    PubMed  CAS  Google Scholar 

  9. Hochberg MC (1997) Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725

    Article  PubMed  CAS  Google Scholar 

  10. Bombardier C, Gladman DD, Urowitz MB et al (1992) Derivation of the SLEDAI: a disease activity index for lupus patients. Arthritis Rheum 35:630–640

    Article  PubMed  CAS  Google Scholar 

  11. Wilson WA, Gharavi AE, Koike T et al (1999) International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome. Arthritis Rheum 42:1309–1311

    Article  PubMed  CAS  Google Scholar 

  12. Pinani CL, Pollock VE (1978) Systemic Lupus Erythematosus (SLE) glomerulnephritis (lupus nephritis). In: Mc Clusker RT, Andre GD (eds) Immunologically mediated renal diseases. N.Y. Marcel Dekker, pp11–69

  13. Davey D, MacGillivray I (1989) The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 161:1422–1423

    Google Scholar 

  14. Whitelaw DA, Spangenberg JJ, Hugo HF (1999) The association between the antiphospholipid antibody syndrome and neurological impairment in SLE. Lupus 8:444–448

    Article  PubMed  CAS  Google Scholar 

  15. Patterson RC, Carpenter M (2003) Perinatal mortality. In Cronje HS, Grobler CJ (eds) Obstetrics in Southern Africa, 2nd edn. Van Schaik Pretoria, pp 695–707

  16. Petri M, Allbritton J (1993) Fetal outcome of lupus pregnancy: a retrospective case-control study of the Hopkins lupus cohort. J Rheumatol 20:650–656

    PubMed  CAS  Google Scholar 

  17. Cortes-Hernandez J, Ordi-Ros J, Paredes F et al (2002) Clinical predictors of fetal and maternal outcome in systemic lupus erythematosus: a prospective study of 103 pregnancies. Rheumatology 41:643–650

    Article  PubMed  CAS  Google Scholar 

  18. Kiss E, Bhattoa HP, Bettembuk P et al (2002) Pregnancy in women with systemic lupus erythematosus. Eur J Obstet Gynecol Reprod Biol 10:101, Mar

    Google Scholar 

  19. Rahman P, Gladman DD, Urowitz MB (1998) Clinical predictors of fetal outcome in systemic lupus erythematosus. J Rheumatol 25:1526–1530

    PubMed  CAS  Google Scholar 

  20. Clark CA, Spitzer KA, Nadler JN et al (2003) Preterm deliveries in women with systemic lupus erythematosus. J Rheumatol 30:2127–2132

    PubMed  Google Scholar 

  21. Levy RA, Vilela VS, Cataldo MJ et al (2001) Hydroxychloroquine (HCQ) in lupus pregnancy: double blind and placebo-controlled study. Lupus 10:401–404

    Article  PubMed  CAS  Google Scholar 

  22. Rubbert A, Pirner K, Wildt L et al (1992) Pregnancy course and complications in patients with systemic lupus erythematosus. Am J. Reprod Immunol 28:205–207

    PubMed  CAS  Google Scholar 

  23. Kobayashi N, Yamada H, Kishida T et al (1996) Hypocomplementemia correlates with intrauterine growth retardation in systemic lupus erythematosus. Am J Reprod Immunol 42:153–159

    Google Scholar 

  24. Jungers P, Dougados M, Pelissier C et al (1982) Lupus nephropathy and pregnancy. Arch Intern Med 142:771–776

    Article  PubMed  CAS  Google Scholar 

  25. Tandon A, Ibanez D, Gladman DD, Urowitz MB (2004) The effect of pregnancy on lupus nephritis. Arthritis Rheum 50:3941–3946

    Article  PubMed  Google Scholar 

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Correspondence to D. A. Whitelaw.

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Whitelaw, D.A., Hall, D. & Kotze, T. Pregnancy in systemic lupus erythematosus: a retrospective study from a developing community. Clin Rheumatol 27, 577–580 (2008). https://doi.org/10.1007/s10067-007-0749-0

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  • DOI: https://doi.org/10.1007/s10067-007-0749-0

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