Maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus:a single center studyMaternal and fetal outcomes in pregnant patients with systemic lupus erythematosus:a single center study

Abstract

Objective: Identify risk factors associated with maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE). Methods: Retrospective analysis of the characteristics and pregnancy outcomes of 283 women with SLE. Results: The mean age at delivery was 29.3±4.7 years, the mean SLE duration was 6.1±4.6 years, and 151 women (53.3%) had adverse pregnancy outcomes (APOs). The APO group had lower levels of C3 and C4, greater level of anti dsDNA antibodies, higher albumin-to-creatinine ratio (ACR), greater frequent history of lupus nephritis (LN), greater use of cyclosporine A (CsA), used higher doses of glucocorticoids (GCs), and had higher disease-activity scores (SLEDAI-2000; all p<0.05). Pregnancy loss (PL) and low birth weight (LBW) infants were also associated with several maternal factors. Multivariate logistic regression analysis showed that low C3 level and CsA use increased the risk of APO, and disease remission for more than 6 months was a protective factor (all p<0.05). A low C3 level increased the risk for PL, and CsA use increased the risk for premature birth (PB; both p<0.05). The dose of GC was associated with APO and PL (both p<0.05), with cut-off values of 8.5 and 9.5 mg/day, respectively. Conclusion: Pregnant women with SLE who have a low level of C3, use CsA, and use higher doses of GCs have an increased risk of APO. Decreased C3 and use of higher doses of GCs increased the risk for PL, and CsA use increased the risk of PB. Pregnancy after 6 months of SLE remission was protective.