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Pregnancy in systemic lupus erythematosus.

ABSTRACT Pregnancy in patients with systemic lupus erythematosus (SLE) poses several well-defined problems. Women with SLE are at increased risk for spontaneous abortion and fetal loss. An increased risk of exacerbation of SLE during pregnancy may occur but is controversial, and SLE flare may easily be confused with pregnancy-induced hypertension. Maternal complications are largely related to disease activity at the time of conception and the presence of hypertension and significant renal dysfunction. Fetal and neonatal complications, including fetal death, are largely predicted by presence of renal disease, antiphospholipid antibody, and anti-SS–A/Ro antibody. Successful pregnancy is possible for many patients with careful prepregnancy evaluation, monitoring, and treatment by both rheumatologist and obstetrician.