Systemic Lupus Erythematosus in Pregnancy

A retrospective analysis of the course of systemic lupus erythematosus in pregnant patients hospitalized at UCLA during a 15-year period provided important prognostic information. Women with systemic lupus erythematosus became pregnant if renal function was reasonably well preserved. Pregnancy infrequently posed a serious threat to the mother; the frequency of nonrenal complications in patients with systemic lupus erythematosus was very low, and the frequency of permanent deterioration of renal function was less than 10%. In contrast, the fetus was at high risk and was adversely affected even if mild renal involvement was detected in the mother. The prevalence of neonatal complications did not increase in the newborn; however, growth retardation did occur in the immediate neonatal period. The pharmacologic management of systemic lupus erythematosus does not require any important modifications in pregnant patients. During labor and in the postpartum period, however, an increase in the dosage of glucocorticoids may reduce postpartum exacerbations.