Rheumatology International

, Volume 31, Issue 9, pp 1153–1157 | Cite as

Systemic lupus erythematosus pregnancies: the Sarawak experience and review of lupus pregnancies in Asia

  • C. L. TehEmail author
  • J. S. Wong
  • N. K. N. Ngeh
  • W. L. H. Loh
Original Article


We performed a cross-sessional study of all systemic lupus erythematosus (SLE) pregnancies during a 4-year period (2006–2009) to describe the clinical features, maternal and foetal outcomes in our centre. There were 48 pregnancies in 44 women with SLE. Our patients have a mean age of 30.0 years (SD 6.36) and a mean disease duration of 40.67 months (SD 48.23). Our patients have complicated pregnancies: 32.7% have SLE flares, 17.3% have preeclampsia and 48.9% needed caesarean sections. There were 20.0% foetal losses and 17.8% preterm deliveries in our patients. SLE flares contributed to 60.0% of foetal losses in our patients. Lupus pregnancies in our centre generally have a good maternal and foetal outcome comparable to developed countries in Asia. The low incidence of APS, the high usage of hydroxychloroquine and the high SLE remission rate in our patients prior to conceptions contributed to the good outcome.


Pregnancies Outcome Systemic lupus erythematosus 



We would like to acknowledge the support of the Ministry of Health, Malaysia for technical support of the study.


  1. 1.
    Clowse MEB (2007) Lupus activity in pregnancy. Rheum Dis Clin North Am 33:237–252PubMedCrossRefGoogle Scholar
  2. 2.
    Clowse MEB, Jamison MG, Myers E et al (2006) National study of medical complications in SLE pregnancies. Arthritis Rheum 54:S263–S264CrossRefGoogle Scholar
  3. 3.
    Petri M (1997) Hopkins Lupus Pregnancy Center: 1987–1996. Rheum Dis Clin North Am 23:1–13PubMedCrossRefGoogle Scholar
  4. 4.
    Carmona F, Font J, Cervera R, Muñoz F, Cararach V, Balasch J (1999) Obstetrical outcome of pregnancy in patients with systemic lupus erythematosus. A study of 60 cases. Eur J Obstet Gynecol Reprod Biol 83:137–142PubMedCrossRefGoogle Scholar
  5. 5.
    Yan Yuen S, Krizova A, Ouimet JM, Pope JE (2008) Pregnancy outcome in systemic lupus erythematosus (SLE) is Improving: results from a case control study and literature review. Open Rheumatol J 2:89–98 Epub 2008 Dec 31PubMedCrossRefGoogle Scholar
  6. 6.
    Tan LK, Tan HK, Lee CT, Tan AS (2002) Outcome of pregnancy in Asian women with systemic lupus erythematosus: experience of a single perinatal centre in Singapore. Ann Acad Med Singapore 31:290–295PubMedGoogle Scholar
  7. 7.
    TambyRaja RL et al (1993) Fetal salvage in maternal systemic lupus erythematosus. Ann Acad Med Singapore 22:634–637PubMedGoogle Scholar
  8. 8.
    Wong CH, Chen TL, Lee CS, Lin CJ, Chen CP (2006) Outcome of pregnancy in patients with systemic lupus erythematosus. Taiwan J Obstet Gynecol 45:120–123PubMedCrossRefGoogle Scholar
  9. 9.
    Mok MY, Leung PY, Lao TH, Lo Y, Chan TM, Wong WS et al (2004) Clinical predictors of fetal and maternal outcome in Chinese patients with systemic lupus erythematosus. Ann Rheum Dis 63:1705–1706PubMedCrossRefGoogle Scholar
  10. 10.
    Chandran V, Aggarwal A, Misra R (2005) Active disease during pregnancy is associated with poor foetal outcome in Indian patients with systemic lupus erythematosus. Rheumatol Int 26:152–156PubMedCrossRefGoogle Scholar
  11. 11.
    Gupta A, Agarwal A, Handa R (2005) Pregnancy in Indian patients with systemic lupus erythematosus. Lupus 14:926–927PubMedCrossRefGoogle Scholar
  12. 12.
    Phadungkiatwattana P, Sirivatanapa P, Tongsong T (2007) Outcomes of pregnancies complicated by (SLE). J Med Assoc Thai 90:1981–1985PubMedGoogle Scholar
  13. 13.
    Sittiwangkul S, Louthrenoo W, Vithayasai P, Sukitawut W (1999) Pregnancy outcome in Thai patients with systemic lupus erythematosus. Asian Pac J Allergy Immunol 17:77–83PubMedGoogle Scholar
  14. 14.
    Song YJ, Liu DZ, Liu JT, Zhao Y (2008) Predictors of maternal and fetal outcome in systemic lupus erythematosus: a retrospective study of 94 cases. Zhonghua Nei Ke Za Zhi 47:1008–1011PubMedGoogle Scholar
  15. 15.
    Foocharoen C, Nanagara R, Salang L, Suwannaroj S, Mahakkanukrauh A (2009) Pregnancy and disease outcome in patients with systemic lupus erythematosus (SLE): a study at Srinagarind Hospital. J Med Assoc Thai 92:167–174PubMedGoogle Scholar
  16. 16.
    Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725PubMedCrossRefGoogle Scholar
  17. 17.
    Buyon JP, Kalunian KC, Ramsay-Goldman R et al (1999) Assessing disease activity in SLE patients during pregnancy. Lupus 8:677–684PubMedCrossRefGoogle Scholar
  18. 18.
    Health Facts Sarawak (2006) Sarawak State Health Department (Information and Documentation Unit)Google Scholar
  19. 19.
    Chakravarthy EF, Nelson L, Krishnan E (2006) Obstetric hospitalizations in the United States for women with systemic lupus erythematosus and rheumatoid arthritis. Arthritis Rheum 54:899–907CrossRefGoogle Scholar
  20. 20.
    Tincani A, Faden D, Tarantini M et al (1992) Systemic lupus erythematosus and pregnancy: a prospective study. Clin Exp Rheumatol 10:439–446PubMedGoogle Scholar
  21. 21.
    Clowse MEB, Magder L, Witter F et al (2006) Hydroxychloroquine in lupus pregnancy. Arthritis Rheum 54:3640–3647PubMedCrossRefGoogle Scholar
  22. 22.
    Jones HW, Ireland R, Senaldi G et al (1991) Anticardiolipin antibodies in patients from Malaysia with systemic lupus erythematosus. Ann Rheum Dis 50:173–175PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • C. L. Teh
    • 1
    • 2
    Email author
  • J. S. Wong
    • 1
    • 2
  • N. K. N. Ngeh
    • 1
    • 2
  • W. L. H. Loh
    • 1
    • 2
  1. 1.Unit of Rheumatology, Department of MedicineSarawak General Hospital, Jalan HospitalKuchingEast Malaysia
  2. 2.Department of Obstetrics and GynaecologySarawak General HospitalKuchingEast Malaysia

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