Maternal and Fetal Outcomes in Systemic Lupus Erythematosus Pregnancies.
10.47102/annals-acadmedsg.2020373
- Author:
Yih Jia POH
1
;
Irene Yuen Lin YII
;
Lim Hee GOH
;
Hui Hua LI
;
Liying YANG
;
Hak Koon TAN
;
Julian THUMBOO
;
Lay Kok TAN
Author Information
1. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.
- Publication Type:Journal Article
- From:Annals of the Academy of Medicine, Singapore
2020;49(12):963-970
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:To describe the maternal and fetal outcomes in systemic lupus erythematosus (SLE) pregnancies followed-up in a single tertiary referral centre.
METHODS:We performed a retrospective cohort study of 75 SLE pregnancies who were followed up in Singapore General Hospital over a 16-year period from 2000 to 2016. Adverse fetal and maternal outcomes including preterm delivery, miscarriages, fetal growth restriction, congenital heart block, neonatal lupus, pre-eclampsia and SLE flares were obtained from the medical records.
RESULTS:The mean age at conception was 32 years old (SD 3.8). The mean SLE disease duration was 5.9 years (SD 5.2). The majority (88%) had quiescent SLE disease activity at baseline. Most pregnancies resulted in a live birth (74.7%). The mean gestational age at birth was 37.4 weeks (SD 3.4). Adverse fetal outcomes occurred in 53.3%. Preterm delivery (33.9%), miscarriages (20%) and fetal growth restriction (17.3%) were the most frequent adverse fetal outcomes. There was 1 neonatal death and SLE flares occurred in a third (33%). In the subgroup of SLE pregnancies with antiphospholipid syndrome, there were higher SLE flare rates (40%) and adverse fetal outcomes occurred in 8 pregnancies (80%). There were no predictive factors identified for all adverse fetal and maternal outcomes. In the subgroup analysis of preterm delivery, anti-Ro (SS-A) antibody positivity and hydroxychloroquine treatment were associated with a lower risk of preterm delivery.
CONCLUSION:Although the majority had quiescent SLE disease activity at baseline, SLE pregnancies were associated with high rates of adverse fetal and maternal outcomes.
