Clinical Question: What is the res...

Clinical Question: What is the result of pregnancy in patients with systemic lupus erythematosus (SLE)?

Setting: Outpatient (specialty)

contemplation Design: Cohort (prospective)

Synopsis: This subject of attention was derived from the Hopkins Lupus Cohort, which included pregnant patients chronicleed between 1987 and 2002. The authors determined the pregnancy results at the time of the first postpartum visit via telephone or mailed review The authors did not include six elective abortions in the analysis.

Among 203 women with SLE 267 pregnancies occurr for which they had whole follow-up. Of the total pregnancies, 229 (86 percent) were live births, 142 (53 percent) of which were replete term. There were 19 miscarriages (7 percent) and 23 infants born between 20 and 28 weeks of gestation (9 percent) Approximately single in kind half (58 percent) of women with active lupus before pregnancy had high lupus activity during pregnancy, compared with simply 8 percent of women with quiescent lupus before pregnancy. Fifty-seven pregnancies occurr in women with moderate to plain SLE activity. Most of the women with increased SLE activity experienced it alone during one trimester. Among the women with high SLE activity as assessed by dint of their physicians, the outcomes were worse. solely 77 percent had live births, 26 percent of which were sated term.

Bottom Line: Women with lupus who become pregnant have high rates of perinatal morbidity and mortality. The results are even worse in women with peremptory SLE. (Level of Evidence: 1b)

investigation Reference: Clowse ME, et al. The impact of increased lupus activity in succession obstetric outcomes. Arthritis Rheum February 2005;52:514-21

Used with permission from Barry H Pregnant SLE patients have high fetal los Accessed online March 31 2005 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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