Pregnancy and reproductive aspects of systemic lupus erythematosus

Purpose of review To discuss pregnancy and reproductive aspects in women with systemic lupus erythematosus (SLE) with particular focus on preconception counselling, maternal and foetal outcomes, safety and beneficial effects of drugs during pregnancy as well as contraception methods, assisted reproduction techniques and strategies for thromboembolism prophylaxis in patients with positive antiphospholipid antibodies. Recent findings Evidence-based recommendations for the management of family planning and women's health issues in SLE and/or APS have been developed by a multidisciplinary panel of experts. The primary aim of these recommendations is to provide a practical tool for facilitating physician-patient communication on reproductive issues. Points-to-consider and guidelines were also released on the use of antirheumatic drugs during pregnancy and lactation. Summary Women with SLE should be timely and periodically counselled on family planning. Preconception counselling and risk stratification (based on disease activity and serological profile) are key points for having successful pregnancies thanks to individualized treatments and close monitoring for maternal and foetal complications. Contraception and assisted reproduction techniques are feasible in women with SLE, provided that potential risks are minimized by individualized management and appropriate prophylaxis.