Pregnancy outcome in Chinese women with systemic lupus erythematosus: a retrospective study of 255 cases in a single center

Purpose: Pregnancy is risky for systemic lupus erythematosus (SLE) women, because it could increase SLE activity and obstetric complications. This study aimed to investigate pregnancy outcome in SLE women, minimize risk of miscarriage, and improve perinatal quality. Patients and methods: Medical records of 282 pregnancies in 280 SLE patients were reviewed retrospectively. Clinical and laboratory data were collected and analyzed. Results: The mean age was 28.25 +/- 4.12 years. In the remaining 255 cases, there were 206 (80.8%) planned pregnancies and 49 unplanned pregnancies. Among 255 SLE pregnancies, there were 215 successful deliveries and 40 fetal losses. The incidence of pregnancy loss, SLE flare, preterm birth and IUGR was significantly higher in unplanned pregnancy group than in planned pregnancy group (P < 0.05). The birth weight and gestational age were significantly higher in planned pregnancy group than unplanned pregnancy group (P < 0.05). Furthermore, it was found that the lupus nephritis group had worse maternal and fetal outcome than the non-lupus nephritis group. Conclusion: Pregnancy in SLE remission phase has a good outcome. Controlling SLE activity, improving renal function is critical to improve pregnancy outcome, especially for nephritis patients. Counselling obstetrician and rheumatologist before pregnancy is an essential step. Furthermore, anti-SSA/Ro antibody is closely related to neonatal lupus and low birth weight. Aspirin is able to improve the birth weight and reduce the incidence of small gestational age.