Disease flare-ups and obstetric outcomes in pregnant women with systemic lupus erythematosus

Abstract

Aim: The purpose of this study was to review the maternal and fetal outcomes in pregnant women with systemic lupus erythematosus (SLE), and to evaluate the prognostic risk factors that may contribute to obstetric outcomes or SLE flare-ups.
Methods: We evaluated 100 births in 97 SLE patients who were seen at Osaka University from 1995 to 2013. Main outcome measures included obstetric outcomes and SLE flare-ups.
Results: The mean patient age was 30.7±4.6 years, and the nulliparity rate was 62.8%. Corticosteroids were taken by 75.3% of the patients, and 48.5% were on a dosage of ≥7.5 mg/day. Disease flare-up and preeclampsia occurred in 17.5% and 11.3% of the patients, respectively. Seven SLE flare-ups (41.2%) occurred after delivery. Fourteen of the patients with a flare-up were taking high dose corticosteroids (≥7.5 mg/day) and showed significantly poorer obstetric outcomes compared to patients taking low dose corticosteroids (<7.5 mg/day) (P=0.0021).
Conclusions: A multidisciplinary approach in the care of pregnant women with SLE is important for good maternal and fetal outcomes. Furthermore, a high daily dosage of corticosteroids may be a prognostic risk factor for adverse SLE flare-ups.