Systemic Lupus Erythematosus and Pregnancy: A Brief Review
- 7 Downloads
Systemic lupus erythematosus is a chronic multisystemic autoimmune disease that predominantly affects young women of childbearing age group. There is a complex immunologic interplay during pregnancy in patients with systemic lupus erythematosus. The pregnancy has direct impact on the disease where an increased rate of flares is noted, and lupus leads to increased risk of hypertensive diseases of pregnancy, preterm birth as well as miscarriages, particularly those with antiphospholipid antibodies. Neonates born to patients with lupus are at increased risk of neonatal lupus as well as heart block if born to patients with positive SSA/SSB. Despite the increased risk of morbidity, recent data suggest improved outcomes in pregnant patients with lupus. A multidisciplinary approach with careful monitoring of pregnancy and lupus could reduce adverse outcomes in these patients. This requires careful pregnancy planning, defining the clinical and serologic involvement of lupus, careful monitoring the patient for adverse pregnancy outcome as well as lupus flares and comprehensive understanding of the drugs that can be safely used in pregnancy. Fetuses should be carefully monitored for heart and neonates for neonatal lupus. Hydroxychloroquine, azathioprine and corticosteroids can be used during pregnancy and may reduce the risk of adverse outcomes. Similarly, appropriate therapy needs to be instituted for hypertensive diseases in pregnancy. Anticoagulant therapy may be necessary for patients with antiphospholipid syndrome.
KeywordsSystemic lupus erythematosus Pregnancy Antiphospholipid syndrome
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 7.Wallace DJ, Hahn BH. Dubois’ lupus erythematosus and related syndromes. 8th ed. Amsterdam: Saunders Elsevier; 2013.Google Scholar
- 8.Clark CA, Spitzer KA, Laskin CA. Decrease in pregnancy loss rates in patients with systemic lupus erythematosus over a 40-year period. J Rheumatol. 2005;32(9):1709–12.Google Scholar
- 13.Clark CA, Spitzer KA, Nadler JN, et al. Preterm deliveries in women with systemic lupus erythematosus. J Rheumatol. 2003;30(10):2127–32.Google Scholar
- 20.Levy RA, Dos Santos FC, de Jesus GR, et al. Antiphospholipid antibodies and antiphospholipid syndrome during pregnancy: diagnostic concepts. Front Immunol. 2015;7(6):205.Google Scholar
- 21.Eudy AM, Siega-Riz AM, Engel SM, et al. Effect of pregnancy on disease flares in patients with systemic lupus erythematosus. Ann Rheum Dis. 2018;77(6):855–60.Google Scholar