Pregnancy outcomes in systemic lupus erythematosus with and without previous nephritis

J Rheumatol. 2011 Sep;38(9):1906-13. doi: 10.3899/jrheum.100997. Epub 2011 Jun 1.

Abstract

Objective: To compare rates and predictors of pregnancy complications in mothers with systemic lupus erythematosus (SLE) with and without previous nephritis (PN).

Methods: Retrospective analysis of 107 pregnancies in 83 women with SLE diagnosed prepregnancy.

Results: Mothers with PN had higher rates of preterm delivery (< 37/40, 30% vs 11%, p = 0.029) than those without PN. Women with PN had earlier onset of preeclampsia [median 34.5 weeks (IQR 32-37) vs 37.5 weeks (IQR 35-38, p = 0.047)] that was more frequently complicated by preterm delivery (p = 0.02). Risk factors for preeclampsia in women with PN include 10-13 weeks' gestation diastolic blood pressure > 80 mmHg and proteinuria, and prepregnancy estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m(2). In women with PN, midtrimester uterine-artery-Doppler notching had low negative predictive value (47%). After 39 months followup, eGFR was stable in women with or without PN.

Conclusion: In SLE, preterm deliveries are more frequent and preeclampsia occurs earlier in women with PN, but longterm eGFR is preserved.

Publication types

  • Comparative Study

MeSH terms

  • Abortion, Spontaneous / diagnostic imaging
  • Abortion, Spontaneous / epidemiology
  • Adult
  • Female
  • Humans
  • Infant, Newborn
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / epidemiology*
  • Lupus Erythematosus, Systemic / therapy
  • Lupus Nephritis / complications*
  • Lupus Nephritis / epidemiology*
  • Lupus Nephritis / therapy
  • Pre-Eclampsia / diagnostic imaging
  • Pre-Eclampsia / epidemiology*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Premature Birth / diagnostic imaging
  • Premature Birth / epidemiology*
  • Retrospective Studies
  • Ultrasonography