Abstract:Fetal outcome in systemic lupus erythematosus (SLE) was retrospectively analysed in 242 pregnancies in 112 unselected patients, and the outcome was compared with that of 417 pregnancies in 192 control women matched for age, parity and socio-economic status. Relative risk for fetal loss after the diagnosis of SLE was 2.5 (95% confidence interval (CI), 1.4-4.5), for prematurity 5.8 (3.2-10.5) and for intra-uterine growth retardation (IUGR) 8.6 (3.0-24.3). Fetal outcome of pregnancy in patients with pre-existing … Show more
“…There were 10 (2.6%) stillbirths in the non-SLE group, similar to 3% reported in the renal transplant literature (53). There were no stillbirths in the SLE group, although published reports cite an expected two-fold increase in stillbirths among nontransplant SLE pregnancies (54,55).…”
Section: Pregnancy Outcomesmentioning
confidence: 69%
“…Prematurity is reported to occur in 24-59% of non-transplant SLE pregnancies (36,46,50,55) compared with 45-60% of renal transplant recipient pregnancies (35,38,53). Preterm birth was common in both groups (SLE 42%, non-SLE 55%).…”
This study compares pregnancy outcomes in systemic lupus erythematosus (SLE) patients post renal transplant with recipients with other primary diagnoses, utilizing data from the National Transplantation Pregnancy Registry, Philadelphia, PA. Recipients were referred from transplant centers nationwide. A retrospective analysis was performed using data from questionnaires, hospital records and telephone interviews. Outcomes of pregnancies post renal transplant secondary to lupus nephritis (SLE: n Ω 38; 60 pregnancies) were compared with the pregnancy outcomes of renal recipients with other diagnoses (non-SLE: n Ω 247; 374 pregnancies). Drug-treated hypertension during pregnancy was less common in the SLE group than in the non-SLE group (45.0% vs. 62.5%, p Ω 0.015). There were fewer cesarean sections in the SLE group (30.2 vs. 53.2%, p Ω 0.008). There was no primary or gestational diabetes in the SLE group. There were no other statistical differences in maternal conditions or pregnancy outcomes between the SLE and non-SLE groups, or in the incidence of post pregnancy graft loss. Female recipients transplanted for renal failure secondary to lupus nephritis can successfully maintain pregnancy. Outcomes are comparable to renal recipients with other diagnoses. Newborns in both groups were often premature and had low birthweight. Overall childhood health was reported to be good; there were no apparent predominant structural malformations among the children.
“…There were 10 (2.6%) stillbirths in the non-SLE group, similar to 3% reported in the renal transplant literature (53). There were no stillbirths in the SLE group, although published reports cite an expected two-fold increase in stillbirths among nontransplant SLE pregnancies (54,55).…”
Section: Pregnancy Outcomesmentioning
confidence: 69%
“…Prematurity is reported to occur in 24-59% of non-transplant SLE pregnancies (36,46,50,55) compared with 45-60% of renal transplant recipient pregnancies (35,38,53). Preterm birth was common in both groups (SLE 42%, non-SLE 55%).…”
This study compares pregnancy outcomes in systemic lupus erythematosus (SLE) patients post renal transplant with recipients with other primary diagnoses, utilizing data from the National Transplantation Pregnancy Registry, Philadelphia, PA. Recipients were referred from transplant centers nationwide. A retrospective analysis was performed using data from questionnaires, hospital records and telephone interviews. Outcomes of pregnancies post renal transplant secondary to lupus nephritis (SLE: n Ω 38; 60 pregnancies) were compared with the pregnancy outcomes of renal recipients with other diagnoses (non-SLE: n Ω 247; 374 pregnancies). Drug-treated hypertension during pregnancy was less common in the SLE group than in the non-SLE group (45.0% vs. 62.5%, p Ω 0.015). There were fewer cesarean sections in the SLE group (30.2 vs. 53.2%, p Ω 0.008). There was no primary or gestational diabetes in the SLE group. There were no other statistical differences in maternal conditions or pregnancy outcomes between the SLE and non-SLE groups, or in the incidence of post pregnancy graft loss. Female recipients transplanted for renal failure secondary to lupus nephritis can successfully maintain pregnancy. Outcomes are comparable to renal recipients with other diagnoses. Newborns in both groups were often premature and had low birthweight. Overall childhood health was reported to be good; there were no apparent predominant structural malformations among the children.
“…As mentioned previously, fetal growth restriction is a serious concern in pregnancies complicated by lupus 44,61 and occurs more frequently in such pregnancies. Fetal growth restriction can occur even before the lupus is apparent in the mother which suggests a pre-disease state.…”
Section: The Effect Of Lupus On Fetal Outcomesmentioning
confidence: 85%
“…18,35,[38][39][40][41][42][43][44] The frequencies of spontaneous abortions and stillbirths are increased in women with lupus, with the stillbirth rate nearly 5 times greater than for non-lupus pregnancies. 20 45 Adverse live birth outcomes correlate with lower pregestational serum albumin levels, elevated gestational anti-double-stranded DNA antibody titers and diabetes.…”
Section: The Effect Of Lupus On Fetal Outcomesmentioning
confidence: 99%
“…17 If pregnancies occur when the lupus disease is active, if there is a history of major organ involvement (e.g., renal or central nervous system), or if there is renal impairment, they are more likely to result in poor fetal and maternal outcomes. 18,[38][39][40][41][42][43][44][48][49][50][51][52][53] Immunosuppressive medications should be minimized or discontinued, provided lupus disease activity is quiescent, to reduce exposure risk to the developing fetus particularly in the first trimester. However, if the patient requires immunosuppressive therapy for maintaining disease control, the woman should be kept on a regimen with the lowest risk to the fetus.…”
Systemic lupus erythematosus is a chronic multi-system autoimmune disease that occurs predominantly in women of childbearing age. The risk of complications and adverse fetal outcomes in pregnant women with lupus is high. Moreover, pregnancy can cause flares of lupus disease activity necessitating maternal immunosuppressive intervention. Interestingly, many potential complications of pregnancy present as symptoms of lupus making diagnosis and treatment a challenge.Advancing technology and better understanding of the maternal-fetal dyad in lupus have improved outcomes in lupus pregnancies over the last 40 years. This article will briefly review the important issues in pregnancies complicated by lupus and provide a general guideline to physicians for monitoring and treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.