Obstetric outcome in systemic lupus erythematosus

Lupus Activity in Pregnancy

“…[6][7][8][9] However, more recent studies have demonstrated a 2 to 3-fold increase in SLE activity during pregnancy. [10][11][12][13] (Table 1) Based on these studies, it appears that between 35-70% of all pregnancies will have measurable SLE activity, with most studies demonstrating the risk to be between 40-50%. 8,9,[11][12][13][14][15][16] The risk for a moderate to severe flare is lower, and ranges between 15-30%.…”

“…[10][11][12][13] (Table 1) Based on these studies, it appears that between 35-70% of all pregnancies will have measurable SLE activity, with most studies demonstrating the risk to be between 40-50%. 8,9,[11][12][13][14][15][16] The risk for a moderate to severe flare is lower, and ranges between 15-30%. [14][15][16] The risk of lupus flare is drastically increased if the woman has had active lupus in the 6 months prior to pregnancy.…”

“…9,13 For women who have worsening renal function due to SLE nephritis during pregnancy, an estimated 25% had continuing renal damage after pregnancy, despite aggressive therapy. 11,13,15 Fortunately, very few women require life-long dialysis.…”

“…3,9,[11][12][13][14][15][16]20 Preterm premature rupture of membranes (PPROM) is a prominent cause of preterm birth among lupus patients. 11,23 While most of the preterm births are spontaneous, a significant proportion of them are induced to protect the health of either the mother or the baby. 3,11 Risk factors for preterm birth include lupus activity prior to and during pregnancy, higher prednisone dose, and hypertension.…”

Systemic Lupus Erythematosus-associated Thrombocytopenia in Pregnancy: Is Splenectomy Necessary at the Time of Delivery?

“…12 However, thrombocytopenia is also common in SLE patients and has been reported to be present in 14% of pregnant SLE patients. 13 Clearly, several aspects of the thrombocytopenia were present in the patient reported here, such as its preexistence before the pregnancy, the severe degree of the thrombocytopenia, and the response to the steroid treatment in 2006, which suggested an SLE-associated thrombocytopenia instead of gestational thrombocytopenia. Of note, the patient's platelet count during the first trimester remained moderately low but was within the range of values observed before her pregnancy.…”