Systemic Lupus Erythematosus (SLE) is an autoimmune disease that occurs when the immune system begins to attack the body’s own tissues. SLE occurs frequently in women at reproductive age, and is associated with pregnancy complications.
Generally, pregnancy outcomes are best for women whose SLE has been inactive for at least six months before pregnancy, and for patients with normal or near-normal renal function. Pregnancy outcomes are worse for women with pulmonary hypertension, restrictive lung disease, heart failure, chronic renal failure, poor obstetrical history, stroke, or recent SLE flares. Pregnant women with SLE are at risk for SLE exacerbation, fetal loss, intrauterine growth restriction (IUGR), preterm birth, and neonatal lupus.
It is difficult to know if there is an increased risk of SLE exacerbation during pregnancy due to issues of reporting bias and lack of a uniform definition of SLE flare. However, most data show that the exacerbation rate is low in women who have been in remission for at least six months.
The diagnosis of a SLE flare can be difficult, since signs and symptoms are similar to preeclampsia, which is also common in women with SLE. Still, it is important to make the distinction between the two, since treatment is different. While the treatment for preeclampsia is delivery, the treatment for lupus flare is increased glucocorticoids and possibly other immunosuppressive therapies.
Adverse Pregnancy Outcomes
Pregnant women with SLE are at increased risk of placental-related diseases, such as preeclampsia, fetal growth restriction, intrauterine fetal death (IUFD), and preterm birth. These may be more common in women with antiphospholipid antibodies or SLE-related comorbidities, such as renal disease and hypertension. Due to the risks, antenatal testing is recommended.
Neonatal lupus is a passively transferred autoimmune disease that occurs in some babies born to mothers with SLE. The most serious complication in the neonate is complete heart block, which occurs in approximately 2 percent of SLE-related pregnancies. Isolated skin rash occurs in a similar percentage, but generally disappears by one year of life.
Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!