Systemic Lupus Erythematosus and Pregnancy

Rheum Dis Clin North Am. 2017 May;43(2):215-226. doi: 10.1016/j.rdc.2016.12.009. Epub 2017 Mar 14.

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease with a strong female predilection. Pregnancy remains a commonly encountered but high-risk situation in this setting. Both maternal and fetal mortality and morbidity are still significantly increased despite improvements in outcomes. Maternal morbidity includes higher risk of disease flares, preeclampsia and other pregnancy-related complications. Fetal issues include higher rates of preterm birth, intrauterine growth restriction, and neonatal lupus syndromes. Treatment options during pregnancy are also limited and maternal benefit has to be weighed against fetal risk. A coordinated approach, with close monitoring by a multidisciplinary team, is essential for optimal outcomes.

Keywords: Antibodies; Fetal loss; Neonatal lupus syndromes; Preeclampsia; Pregnancy; Systemic lupus erythematosus.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Female
  • Fetal Growth Retardation / epidemiology
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Infant, Newborn
  • Lupus Erythematosus, Systemic / congenital
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / epidemiology*
  • Pre-Eclampsia / epidemiology
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / epidemiology*
  • Premature Birth / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Antirheumatic Agents
  • Immunosuppressive Agents
  • Hydroxychloroquine

Supplementary concepts

  • Neonatal Systemic lupus erythematosus