Outcome of Pregnancy in Lupus

Abstract

Background: Pregnancy in patients with SLE is associated with a high risk of maternal disease exacerbation in active disease state and adverse fetal outcome. Objective: To analyse maternal and fetal outcome in pregnant lupus patients as well as to identify influence of disease activity on it. Methods: This retrospective observational cross sectional study was done on 27 pregnant lupus patients in feto-maternal medicine wing of the department of Obstetrics and Gynaecology, BSMMU from April 2007 to March 2011. For statistical analysis z test of proportion and students t test was used. Results: Mean age of the patients was 26.6 years. At booking, 8 (29.63%) had active lupus while 19 (70.37%) was in remission. As complications of SLE, lupus flare was found in 11.1%, lupus nephritis in 25.9% and skin rash in 7.4%. Regarding obstetric complications, PIH was developed in 3.7% and preeclampsia in 11.1% of the patients. Average gestational age at delivery was 34.8 weeks. Birth weight was <2.5kg in 45.8% of neonates. There was IUGR in 33.3% of the cases and 25% of the neonates needed admission in neonatal ICU. There was no neonatal death and none of the 24 neonates had neonatal lupus. In this study there was no maternal mortality. Patients who were in active disease state, most (55.5%) delivered preterm, spontaneous abortion occurred in two and IUD in one of the patients. Average birth weight was lower (1.9+.47kg) in patients with active SLE than those of with remission (2.3+.68kg). Lupus flare developed in 66.6% with active disease, while in 33.3% with remission. Conclusion: Pregnancy is relatively safe with SLE in remission but considered as high risk in terms of fetal loss and spontaneous abortion. Disease activity influences pregnancy outcome.

DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10995

BSMMU J 2012; 5(1):18-23