Pregnancy Outcomes in Chinese Patients with Systemic Lupus Erythematosus (SLE): A Retrospective Study of 109 Pregnancies

PLoS One. 2016 Jul 21;11(7):e0159364. doi: 10.1371/journal.pone.0159364. eCollection 2016.

Abstract

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women during their reproductive years. The interaction between SLE and pregnancy remains debated. The objective of this study was to analyze the fetal and maternal outcomes of Chinese women with SLE. A total of 109 pregnancies in 83 SLE patients from June 2004 to June 2014 at a tertiary university hospital were reviewed retrospectively. Patients' characteristics, clinical and laboratory data during pregnancy were obtained from electronic medical records. After exclusion of elective abortions, the live birth rate was 61.5%. Significantly, APS (antiphospholipid syndrome), disease activity, hypertension, hypocomplementemia, thrombocytopenia, and anemia during pregnancy were more commonly observed in fetal loss pregnancies than in live birth pregnancies. Compared to the 64 women with a history of SLE, 19 women with new-onset lupus during pregnancy had worse pregnancy outcome. Furthermore, the 64 patients with a history of SLE were divided into lupus nephritis group and SLE group (non-renal involvement). We found that the lupus nephritis group had worse maternal outcome than the SLE group. We conclude that new-onset lupus during pregnancy predicts both adverse maternal and fetal outcomes, while a history of lupus nephritis predicts adverse maternal outcomes. It is essential to provide SLE women with progestational counseling and regular multispecialty care during pregnancy.

MeSH terms

  • Adult
  • Asian People*
  • Embryo Loss / pathology
  • Female
  • Humans
  • Kidney / pathology
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Nephritis / complications
  • Pregnancy
  • Pregnancy Outcome*
  • Retrospective Studies
  • Young Adult

Grants and funding

This work was supported by the National Nature Science Foundation of China (NSFC) (No. 81200531 and 81570667 for Shuwang Ge; No. 81470948 and 81270770 for Gang Xu).