Pregnancy Morbidities in Autoimmune Connective Tissue Disease

Connective tissue diseases (CTDs) are a group of diseases affecting both vascular and connective tissue. In our study we chose to focus on patients with SLE for more significant results due to the small number of other CTDs diagnosed in our clinic during this period of time. Our objective was to analyse maternal and fetal outcomes in pregnancies with inactive systemic lupus erythematous (SLE) and lupus nephritis (LN). After applying the inclusion criteria, we selected 35 pregnancies. The outcome in the cases we followed is heterogeneous at least. Concerning fetal outcome - the rate of live births is 91.4% - with 32 cases of life births and 3 cases of stillbirths followed by other 2 cases of neonatal death (5.7%). More so, we were able to diagnose 7 cases (20%) of fetal growth restriction (FGR) and 11 cases (31.4%) of preterm deliveries. We identified several cases of associated maternal pathology - 10 cases (28.5%) of gestational hypertension, 8 cases (22.8%) of preeclampsia and 4 cases (11.4%) of HELLP syndrome. Regarding the renal effects the outcomes were as following: in 8 cases (22.8%) proteinuria >1g/24h and in 5 cases (14.3%) renal flare-up (proteinuria >= 2g/24h +/-microscopic haematuria). Our final discovery concerns the mode of delivery: in 29 (82.9%) out of the 35 cases a C-section was necessary while only in 6 (17.1%) out of 35 cases a vaginal birth took place. We hereby insist on the necessity of preconception counselling, optimal timing of pregnancy and a multidisciplinary approach in all women with CTDs that wish to conceive or are pregnant.