Systemic Lupus Erythematosus and Pregnancy

SummarySystemic lupus erythematosus mostly affects women of childbearing age. Fertility does not seem to be affected by the disease. There is an increased incidence in spontaneous abortion and prematurity. The vast majority of babies born to mothers with lupus are normal at birth and Ihrive normally. Abnormal maternal antibodies have been found in the foetal circulation, some of them causing haematological disturbances. There is an increasing list of reports of mothers with a connective tissue disease such as lupus or rheumatoid arthritis, giving birth to a neonate with a transient lupus-like rash or, more important, with a congenital complete heart block.Despite the increased number of lupus exaceibations during pregnancy and especially early postpartum, pregnancy per se does not seem to affect maternal survival. Ideally, lupus disease should be quiescent for about one year before the start of a pregnancy. Opinions on the relationship between pregnancy and lupus nephritis are conflicting. The renal outcome during pregnancy seems to be related to the type and severity of the histological lesions at the start of gestation. Corticosteroid therapy will reduce the number and severity of lupus exacerbations during pregnancy and early postpartum. An extra dose of corticosteroids is recommended during the last month of pregnancy and should be maintained during the eight weeks postpartum. Therapeutic abortion has no benefical effect in the treatment of S.L.E.exacerbations during pregnancy.