Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Pregnancy Outcomes and Fetal Complications in Patients with Systemic Lupus Erythematosus: a Retrospective Analysis in Korea.
Park1, Eun-Jung, Hwang1, Jiwon, Lee2, Jaejoon, Ahn3, Joong Kyong, Jeon4, Chan Hong, Cha1, Hoon-Suk, Koh1, Eun-Mi
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea
Kangbuk Samsung hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
Soonchunhyang University College of Medicine, Bucheon, South Korea
Systemic lupus erythematosus (SLE) predominantly affects women in reproductive year. The effect of pregnancy on the SLE disease activity and the influence of SLE activity on pregnancy outcomes are major concerns in the management of SLE. The aim of this study is to evaluate the pregnancy outcomes in SLE patients and to investigate the impact of pregnancy on disease activity and the effect of lupus activity on pregnancy with respect to fetal complications.
All pregnancies with SLE seen at Samsung Medical Center between November 1994 and December 2010 were included and retrospectively analyzed. Demographics, clinical manifestations, laboratory data and fetal outcomes were evaluated. SLE flare was determined by Lupus Activity Index-Pregnancy (LAI-P) score. Logistic regression analysis was used to determine the predictive factors for fetal complications.
Sixty-two pregnancies were observed among 50 patients. Of these, 51 (82.3 %) live births and 11 (17.7%) fetal losses were seen. Of live births, 38 (74.5 %) full-term births and 13 (25.5 %) preterm births occurred. Thirteen cases of low birth weight and 9 intrauterine growth retardations were noted. Fetal losses included 3 spontaneous abortions, 2 stillbirths, and 6 therapeutic abortions. Proteinuria, 0.5g per day or more, during pregnancy was found to be a predictive factor for fetal complications adjusting for age, history of previous lupus nephritis, and history of steroid use (adjusted OR 5.59; P = 0.024). LAI-P score measurement was available in 36 pregnancies. Of these, SLE flare occurred in 12 pregnancies (33.3 %), mainly during the second trimester (37.5%). Renal involvement (69.2 %) was found to be the most common SLE flare during pregnancy, followed by thrombocytopenia (15.4 %), serositis (7.7 %) and vasculitis (7.7%). All flares were classified as severe flare according to LAI-P score. As expected, fetal losses, prematurity and low birth weights were observed more frequently in the flare group whereas live births and full-term births were observed more frequently in those without SLE flare.
Our data demonstrated a relatively higher rate of live births and lower rate of fetal losses in patients with SLE compared to previous reports. The rate of lupus flares during pregnancy was also lower and renal flare was the most common manifestation. Proteinuria, 0.5g per day or more, during pregnancy was found to be the sole predictive factor for fetal complications.
To cite this abstract, please use the following information:
Park, Eun-Jung, Hwang, Jiwon, Lee, Jaejoon, Ahn, Joong Kyong, Jeon, Chan Hong, Cha, Hoon-Suk, et al; Pregnancy Outcomes and Fetal Complications in Patients with Systemic Lupus Erythematosus: a Retrospective Analysis in Korea. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1413