Clinical Rheumatology

, 27:577 | Cite as

Pregnancy in systemic lupus erythematosus: a retrospective study from a developing community

  • D. A. WhitelawEmail author
  • D. Hall
  • T. Kotze
Original Article


Little data exists from the developing world on pregnancy in systemic lupus erythematosus (SLE). A 10-year review of pregnancies in lupus patients was conducted at a tertiary hospital in a developing country. Forty-seven pregnancies in 31 patients were identified. Eleven (23%) booked after 20 weeks gestation. There were no maternal deaths; six (13%) mothers experienced flares—all mild. Twelve women developed preeclampsia of which one experienced an intrauterine death. One patient was diagnosed with lupus and nephritis during pregnancy. She required an abortion to control the disease. Another with active nephritis delivered a normal but premature infant despite cyclophosphamide therapy. There was only minor deterioration in renal function. There were 36 (77%) live births, 8 first trimester abortions, 2 elective abortions and 1 still birth. Fourteen (39%) of live births were premature, and five (14%) experienced intrauterine growth retardation (IUGR). Two live-born babies experienced neonatal heartblock, and one, a neonatal lupus rash. We discuss these finding in relation to risk factors and to results from the developed world.


Outcome Pregnancy Risk factors SLE 


  1. 1.
    Merrill JA (1955) Cortisone in disseminated lupus erythematosus during pregnancy. Obstets and Gynaecol 6:637–642CrossRefGoogle Scholar
  2. 2.
    Fine LG (1981) Systemic lupus erythematosus in pregnancy. Ann Intern Medicine 94:667–677Google Scholar
  3. 3.
    Petri M (2004) Prospective study of systemic lupus erythematosus pregnancies. Lupus 13:688–689PubMedCrossRefGoogle Scholar
  4. 4.
    Carmona F, Font J, Cervera R et al (1999) Obstetrical outcome of pregnancy in patients with systemic lupus erythematosus. A study of 60 cases. Eur J of Obsts Gynecol Reproduct Biol 83:137–142CrossRefGoogle Scholar
  5. 5.
    Georgiou PE, Politi EN, Katsimbri P et al (2000) Outcome of lupus pregnancy: a controlled study. Rheumatology 39:1014–1019PubMedCrossRefGoogle Scholar
  6. 6.
    Le Thi Huong D, Wechsler B, Piette J-C et al (1994) Pregnancy and its outcome in systemic lupus erythematosus. Q J Med 87:721–729Google Scholar
  7. 7.
    Aggarwal N, Sawhney H, Vasishta K et al (1999) Pregnancy in patients with systemic lupus Erythematosus. Aust N Z J Obstets and Gynaecol 31:28–30CrossRefGoogle Scholar
  8. 8.
    Tan LK, Tan HK, Lee CT et al (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
  9. 9.
    Hochberg MC (1997) Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725PubMedCrossRefGoogle Scholar
  10. 10.
    Bombardier C, Gladman DD, Urowitz MB et al (1992) Derivation of the SLEDAI: a disease activity index for lupus patients. Arthritis Rheum 35:630–640PubMedCrossRefGoogle Scholar
  11. 11.
    Wilson WA, Gharavi AE, Koike T et al (1999) International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome. Arthritis Rheum 42:1309–1311PubMedCrossRefGoogle Scholar
  12. 12.
    Pinani CL, Pollock VE (1978) Systemic Lupus Erythematosus (SLE) glomerulnephritis (lupus nephritis). In: Mc Clusker RT, Andre GD (eds) Immunologically mediated renal diseases. N.Y. Marcel Dekker, pp11–69Google Scholar
  13. 13.
    Davey D, MacGillivray I (1989) The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 161:1422–1423Google Scholar
  14. 14.
    Whitelaw DA, Spangenberg JJ, Hugo HF (1999) The association between the antiphospholipid antibody syndrome and neurological impairment in SLE. Lupus 8:444–448PubMedCrossRefGoogle Scholar
  15. 15.
    Patterson RC, Carpenter M (2003) Perinatal mortality. In Cronje HS, Grobler CJ (eds) Obstetrics in Southern Africa, 2nd edn. Van Schaik Pretoria, pp 695–707Google Scholar
  16. 16.
    Petri M, Allbritton J (1993) Fetal outcome of lupus pregnancy: a retrospective case-control study of the Hopkins lupus cohort. J Rheumatol 20:650–656PubMedGoogle Scholar
  17. 17.
    Cortes-Hernandez J, Ordi-Ros J, Paredes F et al (2002) Clinical predictors of fetal and maternal outcome in systemic lupus erythematosus: a prospective study of 103 pregnancies. Rheumatology 41:643–650PubMedCrossRefGoogle Scholar
  18. 18.
    Kiss E, Bhattoa HP, Bettembuk P et al (2002) Pregnancy in women with systemic lupus erythematosus. Eur J Obstet Gynecol Reprod Biol 10:101, MarGoogle Scholar
  19. 19.
    Rahman P, Gladman DD, Urowitz MB (1998) Clinical predictors of fetal outcome in systemic lupus erythematosus. J Rheumatol 25:1526–1530PubMedGoogle Scholar
  20. 20.
    Clark CA, Spitzer KA, Nadler JN et al (2003) Preterm deliveries in women with systemic lupus erythematosus. J Rheumatol 30:2127–2132PubMedGoogle Scholar
  21. 21.
    Levy RA, Vilela VS, Cataldo MJ et al (2001) Hydroxychloroquine (HCQ) in lupus pregnancy: double blind and placebo-controlled study. Lupus 10:401–404PubMedCrossRefGoogle Scholar
  22. 22.
    Rubbert A, Pirner K, Wildt L et al (1992) Pregnancy course and complications in patients with systemic lupus erythematosus. Am J. Reprod Immunol 28:205–207PubMedGoogle Scholar
  23. 23.
    Kobayashi N, Yamada H, Kishida T et al (1996) Hypocomplementemia correlates with intrauterine growth retardation in systemic lupus erythematosus. Am J Reprod Immunol 42:153–159Google Scholar
  24. 24.
    Jungers P, Dougados M, Pelissier C et al (1982) Lupus nephropathy and pregnancy. Arch Intern Med 142:771–776PubMedCrossRefGoogle Scholar
  25. 25.
    Tandon A, Ibanez D, Gladman DD, Urowitz MB (2004) The effect of pregnancy on lupus nephritis. Arthritis Rheum 50:3941–3946PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  1. 1.Division of RheumatologyStellenbosch University and Tygerberg HospitalBellvilleSouth Africa
  2. 2.Department of Obstetrics and GynaecologyStellenbosch University and Tygerberg HospitalBellvilleSouth Africa

Personalised recommendations