Pregnancy in systemic lupus erythematosus

Dina Zucchi; Rebecca Fischer-Betz; Chiara Tani

doi:10.1016/j.berh.2023.101860

Pregnancy in systemic lupus erythematosus

Best Pract Res Clin Rheumatol. 2023 Aug 16:101860. doi: 10.1016/j.berh.2023.101860. Online ahead of print.

Authors

Dina Zucchi¹, Rebecca Fischer-Betz², Chiara Tani³

Affiliations

¹ Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa, Italy; Department of Medical Biotechnologies, University of Siena, Italy.
² Medical Faculty, Department Rheumatology & Hiller-Research Unit Rheumatology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
³ Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa, Italy. Electronic address: chiara.tani@for.unipi.it.

PMID: 37596173
DOI: 10.1016/j.berh.2023.101860

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which frequently affects women of childbearing age. Nowadays, pregnancy is not contraindicated in cases of well-controlled disease activity, but pregnancies are still at higher risk of maternal and fetal complications compared to the general population. During pregnancy and puerperium patients are at risk of disease flare, and obstetric complications are more frequent in cases of active disease at conception/beginning of pregnancy, a history of lupus nephritis, and concomitant presence of antiphospholipid syndrome. To improve pregnancy outcomes in SLE patients, appropriate preconception counseling with changes in medication, if necessary, and close rheumatological and obstetrical monitoring are fundamental. This review aims to summarize the risk factors for adverse pregnancy outcomes and provide an update on developments in medical care for pregnancy in SLE patients.

Keywords: Fetal loss; Lupus nephritis; Preeclampsia; Pregnancy; Systemic lupus erythematosus.

Publication types

Review