Pregnancy outcomes and risk factors in pregnant women with systemic lupus erythematosus

Abstract

Objective: To analyze the pregnancy outcomes and risk factors in pregnant women with systemic lupus erythematosus (SLE), for providing a reference for the clinical diagnosis and treatment of the SLE. Materials and Methods: Seventy-eight SLE patients with 82 pregnancies were enrolled in this study. The general information of patients, maternal history data, clinical symptoms, and laboratory examination data one to three months before pregnancy, during pregnancy, at delivery and after childbirth, drug treatment, and pregnancy outcomes were collected. The single factor and logistic regression analyses of the risk factors related to SLE with deterioration and fetal loss were performed. Results: The single-factor analysis showed that there was significant difference in complement 3, 24-hour urinary protein, anti-dsDNA antibody, anti-CL antibody, pre-pregnancy prednisone dose, and SLE disease activity index (SLEDAI) between SLE with deterioration group and SLE without deterioration group, respectively (p < 0.05 or p < 0.01), with significant difference in complement 3, combined antiphospholipid syndrome (APS), SLEDAI, and SLE deterioration during pregnancy between fetal loss group and live birth group, respectively (p < 0.01). The multi-factor regression analysis showed that, the complement 3 and SLEDAI were the main risk factors of SLE with deterioration during pregnancy, and the combined APS and SLEDAI were the main risk factors of fetal loss. Conclusion: The pregnancy has a high risk in women with SLE. The complement 3 and SLEDAI are the main risk factors of SLE with deterioration during pregnancy, and the combined APS and SLEDAI are the main risk factors of fetal loss. The reasonable and effective strategies should be formulated based on these factors, in order to reduce the risk of adverse pregnancy outcomes.