MATERNAL AND FETAL OUTCOME OF PREGNANCY IN SLE: A SINGLE CENTER SURVEY FROM PAKISTAN

S MUNIR; S MUSHTAQ; J AMIN; S SIDDIQUE; S JAMIL; MA AWAIS

doi:10.54112/bcsrj.v2024i1.1166

Authors

S MUNIR Sheikh Zayed Hospital, Lahore
S MUSHTAQ Government General Ghaziabad Hospital, Lahore
J AMIN Government Teaching Hospital, Shahdara/FJMU, Lahore
S SIDDIQUE Mayo Hospital, Lahore.
S JAMIL Lady Aitchison Hospital, Lahore
MA AWAIS Omer hospital, Lahore.

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1166

Keywords:

Systemic Lupus Erythematosus Pregnancy Complications toimmune Diseases Fetal Growth Retardation Pregnancy Outcome

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with multifactorial origins, affecting multiple organ systems. Pregnancy in women with SLE is associated with a higher risk of complications and adverse outcomes. This study aimed to evaluate maternal and fetal outcomes in pregnant patients with SLE. Objective: To analyse the maternal and fetal pregnancy outcomes in patients with SLE. Methods: This cross-sectional study was conducted over six months, from Jan 2024 to July 2024, after approval from the institutional ethical review board. Sixty-six pregnant women with SLE were enrolled based on specific inclusion and exclusion criteria. Detailed medical histories were collected, and patients were followed throughout pregnancy for maternal and fetal outcomes. Data was analyzed using SPSS version 26.0. Results: The mean age of the participants was 35.11 ± 7.27 years. Maternal complications included SLE flare in 47 (71.2%) patients, onset of disease during pregnancy in 4 (6.1%) patients, and normal pregnancy in only 15 (22.7%) cases. Fetal outcomes revealed intrauterine growth retardation (IUGR) in 12 (18.2%) cases and intrauterine death in 5 (7.6%) cases. Conclusion: Pregnancy in women with SLE is associated with significant maternal and fetal complications. The high prevalence of adverse outcomes underscores the need for careful monitoring and specialised care during pregnancy to improve prognoses.

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References

- Ha E, Bae SC, Kim K. Recent advances in understanding the genetic basis of systemic lupus erythematosus. InSeminars in immunopathology 2022 Jan (Vol. 44, No. 1, pp. 29-46). Berlin/Heidelberg: Springer Berlin Heidelberg.

- Kalok A, Abdul Cader R, Indirayani I, Abdul Karim AK, Shah SA, Mohamed Ismail NA, Omar MH, Shafiee MN. Pregnancy outcomes in systemic lupus erythematosus (SLE) women. Hormone Molecular Biology and Clinical Investigation. 2019 Dec 18;40(3):20190007.

- Bundhun PK, Soogund MZ, Huang F. Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy: a meta-analysis of studies published between years 2001–2016. Journal of autoimmunity. 2017 May 1;79:17-27.

- Ceccarelli F, Perricone C, Massaro L et al. Assessment of disease activity in systemic lupus erythematosus: lights and shadows. Autoimmun Rev 2015;14:601–8.

- Jakobsen IM, Helmig RB, Stengaard-Pedersen K. Maternal and foetal outcomes in pregnant systemic lupus erythematosus patients: an incident cohort from a stable referral population followed during 1990–2010. Scandinavian journal of rheumatology. 2015 Sep 3;44(5):377-84.

- Skorpen CG, Lydersen S, Gilboe IM et al. Influence of disease activity and medications on offspring birth weight, pre-eclampsia and preterm birth in systemic lupus erythematosus: a population-based study. Ann Rheum Dis 2018;77:264–9.

- Yan Yuen S, Krizova A, Ouimet JM, Pope JE. Pregnancy outcome in systemic lupus erythematosus (SLE) is improving: results from a case control study and literature review. Open Rheumatol J 2009;2:89–98.

- Khan A, Thomas M, PK SD. Pregnancy complicated by systemic lupus erythematosus and its outcome over 10 years. Journal of Obstetrics and Gynaecology. 2018 May 19;38(4):476-81.

- Andrade R, Sanchez ML, Alarcón GS, Fessler BJ, Fernández M, Bertoli AM, Apte M, Vilá LM, Arango AM, Reveille JD. Adverse pregnancy outcomes in women with systemic lupus erythematosus from a multiethnic US cohort: LUMINA (LUI). Clinical and experimental rheumatology. 2008 Mar 1;26(2):268.

- Clowse ME, Jamison M, Myers E, James AH. A national study of the complications of lupus in pregnancy. Am J Obstet Gynecol 2008;199:127.e1–6.

- Petri M. Pregnancy and systemic lupus erythematosus. Best Practice & Research Clinical Obstetrics & Gynaecology. 2020 Apr 1;64:24-30.

- Andreoli L, Bertsias GK, Agmon-Levin N et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 2017;76:476–485.

- Chen YJ, Chang JC, Lai EL et al. Maternal and perinatal outcomes of pregnancies in systemic lupus erythematosus: a nationwide population-based study. Semin Arthritis Rheum. 2020;50:451–7.

- Buyon JP, Kim MY, Guerra MM et al. Predictors of pregnancy outcomes in patients with lupus: a cohort study. Ann Intern Med 2015;163:153–63.

- Chen D, Lao M, Zhang J, Zhan Y, Li W, Cai X, Zhan Z. Fetal and maternal outcomes of planned pregnancy in patients with systemic lupus erythematosus: a retrospective multicenter study. Journal of immunology research. 2018;2018(1):2413637.

- Pastore DE, Costa ML, Surita FG. Systemic lupus erythematosus and pregnancy: the challenge of improving antenatal care and outcomes. Lupus. 2019 Oct;28(12):1417-26.