The Role of Lupus Nephritis in Development of Adverse Maternal and Fetal Outcomes during Pregnancy

Abstract

Background: We aimed to investigate the relationship of lupus nephritis (LN) with fetal and maternal outcomes of pregnant patients with systemic lupus erythematosus (SLE).

Methods: In a retrospective study, profiles of pregnant women with SLE were selected. Before pregnancy and at the end of first, second and third trimesters, SLE disease activity index-2K was assessed. Clinical and laboratory evaluations were carried out regularly. Maternal and fetal outcomes were recorded. Assessments of the crude effects of statistically significant variables on pregnancy outcomes were performed through multivariate regression analysis.

Results: 72 pregnancies in 65 patients were recorded. The mean age of LN patients was 28.7 years, whereas the mean age of patients with clinical nephritis was 26.1 years. No woman with LN experienced pre-term labor or stillbirth. 16 pregnancies either ended in abortion or experienced preeclampsia of which seven had LN. Multivariate logistic regression analyses showed that LN and positive antinuclear antibody were related to preeclampsia, whereas age of SLE development was associated with pre-term labor. Combined maternal and fetal outcomes were associated with the past history of abortion and LN. LN was associated with preeclampsia and SLE flare.

Conclusions: Absence of LN was in favor of prevention of SLE flare and preeclampsia.

Keywords: Iran, lupus nephritis, outcome, pregnancy, systemic lupus erythematosus