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Pregnancy Outcomes in Japanese Patients with SLE: Retrospective Review of 55 Pregnancies at a University Hospital

Clinical Reviews in Allergy & Immunology volume 44, pages 57–64 (2013)Cite this article

Abstract

Systemic lupus erythematosus (SLE) is mainly a disease of fertile women and the coexistence of pregnancy is by no means a rare event. How SLE and its treatment affect pregnancy outcomes is still a matter of debate. We performed a retrospective analysis of 41 SLE patients (55 pregnancies) who were followed at our university hospital from January 2000 to December 2009. The mean age of patients was 30.6 ± 4.8 years and mean disease duration was 6.6 ± 5.3 years. After exclusion of artificial abortions, live birth rate was 84%. Significantly, more women with stillbirth pregnancies were complicated with antiphospholipid syndrome (APS) than women with live birth pregnancies (two of eight stillbirth pregnancies (25%) versus one of 42 live birth pregnancies (2%); p = 0.014) and hypocomplementemia at conception (four of eight stillbirth pregnancies (50%) versus six of 42 live birth pregnancies (14%); p = 0.021). Compared with nonrenal pregnancies, renal pregnancies were younger at SLE disease onset, had a lower positivity of anti-RNP antibody, and were more complicated with pregnancy-induced hypertension. Past maximum dose of prednisolone, the dose of prednisolone at conception, and percentage of past steroid pulse therapy were higher in renal pregnancies. Outcomes of pregnancies were not significantly different both for mothers and for infants between renal and nonrenal pregnancies. We conclude that it is necessary to provide SLE mothers with the proper information before pregnancy. Women with APS or hypocomplementemia should be regarded with particular attention. Optimal management of mothers and infants requires collaborative efforts of rheumatologists and obstetricians.

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Competing Interests

The authors have received no financial support or other benefits from commercial sources for the work reported here, and the authors have no other financial interests that could create a potential conflict of interest or the appearance of a conflict of interest with regard to the present study.

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Affiliations

  1. Center for Rheumatic Diseases, Yokohama City University Medical Center, 4–57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232–0024, Japan

    Haruko Ideguchi, Shigeru Ohno & Takeaki Uehara

  2. Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Yoshiaki Ishigatsubo

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  1. Haruko Ideguchi
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  2. Shigeru Ohno
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  3. Takeaki Uehara
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  4. Yoshiaki Ishigatsubo
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Correspondence to Haruko Ideguchi.

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Ideguchi, H., Ohno, S., Uehara, T. et al. Pregnancy Outcomes in Japanese Patients with SLE: Retrospective Review of 55 Pregnancies at a University Hospital. Clinic Rev Allerg Immunol 44, 57–64 (2013). https://doi.org/10.1007/s12016-011-8269-8

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  • DOI: https://doi.org/10.1007/s12016-011-8269-8

Keywords

  • Systemic lupus erythematosus
  • Pregnancy
  • Antiphospholipid syndrome
  • Hypocomplementemia
  • Nephritis