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Effects of perinatal disease activity on offspring's growth in patients with systemic lupus erythematosus

To systematically analyze the associations of perinatal disease activity with adverse outcomes of Chinese patients with systemic lupus erythematosus (SLE) and their offspring.Data of prenatal SLE patients and healthy pregnant woman admitted to our hospital during October 2001 to January 2018 were retrospectively collected, and the status of SLE offspring was followed-up in March 2020. Disease activity was evaluated by SLE disease activity index 2000 (SLEDAI-2k), and those with scores > 6 were defined as having active disease.Totally 198 deliveries of 194 SLE patients and 199 deliveries of healthy women were documented. Maternal and fetal adverse outcomes occurred in 74 (37.4%) and 90 (45.5%) deliveries of SLE patients respectively, which was significantly higher than those of healthy subjects. Among SLE patients, the active group had higher rates of gestational hypertension (p<0.001), preeclampsia/eclampsia (p<0.001), low birth weight (p<0.001), premature birth (p<0.001) and fetal growth restriction (FGR) (p<0.01) than inactive group. Multivariate logistic analysis revealed that perinatal renal activity was associated with gestational hypertension (OR 4.43, p<0.001), preeclampsia/ eclampsia (OR 9.14, p<0.001), low birth weight (OR 2.24, p<0.05) and premature birth (OR 4.20, p<0.001). Compared with the general population, SLE offspring had relatively high rates of eczema (50/142 35.2%) and congenital heart disease (6/142 4.2%), which were irrelevant to perinatal disease activity, but related to specific antibodies.For perinatal SLE women, renal activity is associated with a variety of adverse pregnancy outcomes. However, maternal perinatal disease activity does not seem to affect the growth of their offspring.