Systemic lupus erythematosus and pregnancy: A retrospective study

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease predominantly affecting young women, often complicating pregnancy. This study evaluates the interplay between SLE and pregnancy, focusing on maternal and fetal outcomes. Methods: A retrospective study was conducted at Ibn El Jazzar University Hospital, Kairouan, Tunisia, from 2008 to 2015, including 13 pregnant women with SLE diagnosed per American College of Rheumatology (ACR) criteria. Data on demographics, SLE activity, obstetric management, and outcomes were collected from medical records. Results: Mean maternal age was 33 years (range: 24-47). SLE was active in 46.6% of cases. Pre-eclampsia occurred in 30.8%, with two cases of HELLP syndrome. Fetal outcomes included 76.9% live births, 15.4% intrauterine fetal deaths, and one spontaneous abortion. Neonatal complications included prematurity (23%) and growth restriction (38.5%). No neonatal lupus was observed. Postpartum complications included hemorrhage (7.7%) and endometritis (15.4%). Hydroxychloroquine was maintained in most cases, with corticosteroids and heparin widely used. Conclusion: SLE pregnancies carry elevated risks of pre- eclampsia, fetal loss, and prematurity, necessitating multidisciplinary management. Maintaining hydroxychloroquine and tailored anticoagulation improve outcomes. A proposed protocol emphasizes pre-conception counseling and regular monitoring.